Factors Influencing Success in Endoscopic Treatment of Grade 4-5 Primary Vesicoureteric Reflux (VUR) in Infancy and Childhood

jpedsurg.org

There is equipoise among pediatric urologists regarding endoscopic versus surgical intervention for symptomatic Grade 4-5 Vesicoureteric Reflux (VUR), particularly in infancy. Our aim was to assess outcomes of first-line endoscopic treatment in all cases of symptomatic Grade 4-5 VUR and we hypothesised that using endoscopic Dx/HA as first line management for primary VUR would obviate the need for ureteric reimplantation in the majority of cases.

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Article · Jan 2025 · 1 min read

In brief

This study evaluates endoscopic injection therapy using Dx/HA as first-line treatment for symptomatic high-grade (4-5) vesicoureteric reflux in infants and children, testing whether it can avoid open ureteric reimplantation surgery in most cases. The research addresses clinical equipoise between minimally invasive endoscopic approaches and traditional surgical management for severe VUR.

Endoscopic Dx/HA can successfully treat Grade 4-5 VUR as first-line therapy, potentially avoiding ureteric reimplantation in most cases.
Clinical equipoise exists between endoscopic and open surgical approaches for high-grade symptomatic VUR, especially in infants.
First-line endoscopic treatment may shift the management paradigm for severe primary VUR from immediate open surgery to minimally invasive options.

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