Results of Preference of Subureteric Injection or Ureteroneocystostomy As the Initial or Subsequent Surgical Intervention in Vesicoureteral Reflux

Abstract

The incidence of vesicoretral reflux (VUR) in childhood is 0.4-1.8%. Among the surgical treatment options, there are two different approaches: Subureteric injection (SUI) and ureteroneocystostomy (UNC). In this study, we evaluated the operation results of patients who underwent SUI and UNC for VUR. Patients who underwent surgical treatment for vesicoureteral reflux in a tertiary university hospital between 2010-2018 were retrospectively analyzed. The surgical techniques applied to the patients, whether the procedure was successful or not, and additional interventions needed afterwards were recorded. The success rates of the two different techniques applied were compared. Of the 274 patients included in the study, 219 received SUI as the first procedure, 57% of patients did not need additional intervention. After the first SUI, 13.1% of patients underwent UNC as the second procedure. A second SUI was given to 21.2% of patients. UNC was given to 5.5% of patients who received two injections, and 4% of patients were underwent a third SUI. 59.8% patients were treated with SUI alone. Reflux was treated in 65.6% of patients with a single procedure. In VUR patients, SUI should be the first treatment choice because of its high success rate, low complication risk and not preventing UNC.