Secondary surgery for vesicoureteral reflux after failed endoscopic injection: Comparison to primary surgery

Abstract

PurposeAs endoscopic treatment for vesicoureteral reflux (VUR) has increased, secondary ureteral reimplantation (UR) after failure of endoscopic treatment has increased. We studied the clinical feature and efficacy of secondary UR after failure of endoscopic treatment compared with primary UR.Materials and MethodsEighty-one children who had UR for VUR were enrolled. Charts were reviewed retrospectively for age, sex, grade of VUR before surgery, operative time, hospitalization period, postoperative complication, and success rate. Primary UR (group A, n=64) was compared with secondary UR after failed endoscopic treatment (group B, n=17). In group B, telephone survey for the satisfaction of endoscopic treatment and surgery was done.ResultsMean age of each group was 49.6±37.1 and 56.6±22.5 months (p=0.236). There was no significant difference between each group in sex, mean operative time, postoperative transfusion, complication rate, and success rate. As telephone survey in group B, eleven responders preferred endoscopic treatment as primary treatment of VUR because it was a simple method and no hospitalization.ConclusionsSecondary UR after failure of endoscopic treatment was similar to primary UR. Parents preferred endoscopic treatment as first line treatment for VUR in spite of the need for secondary UR after failure of endoscopic treatment.

Comparison of Cohen and Lich-Gregoir ureteral reimplantation in the surgical management of primary unilateral vesicoureteral reflux in children

“…The effect of endoscopic injections prior to open UNC on success rates is another argument in the literature. Lee et al 21 reported that there were no significant differences in operative time, hospitalization time, postoperative complications, and success rates among open ureteral reimplantation techniques after previous failed endoscopic injection for primary VUR. Previous endoscopic injection surgery had no negative effect on our surgical results.…”