engleski

Endoscopic treatment of vesicoureteral reflux in children

Vesico-ureteral reflux (VUR) is an abnormal movement of urine from the bladder into ureters or kidneys and it is the most common urological malformation in pediatric age. Nevertheless its optimal management remains controversial. Until 80's, treatment guidelines for VUR recommended the use of antibiotic prophylaxis as initial therapy, with surgical repair for patients with persistent VUR. Nowadays endoscopic subureteral injection of tissue augmenting substances has become a golden standard for the management of VUR and an established alternative to long-term antibiotic prophylaxis and open surgery. Recently, dextranomer/hyaluronic acid copolymer a biodegradable injectable material has been reported to be a promising alternative to other tissue augmenting substances. The endoscopic procedure meets all the criteria of minimally invasive surgery. Most authors agree that in the case of failure of first or second injection, third injection should be performed. The success of this method of treatment is 80-96%. Open surgery would be reserved only for use in children not responding to endoscopic treatment and those with severe ureteral anomalies.

antibiotic prophylaxis; childhood disease; gold standard; human; minimally invasive surgery; practice guideline; review; urinary tract malformation; vesicoureteral reflux; hyaluronic acid

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