22 May Endoscopic Treatment of Vesicoureteral Reflux

Based on today’s knowledge, endoscopic treatment may be considered as first line therapy for most children with persistent high grade (III-V) reflux. Those with grade II-V with scarred kidneys or ureteral anomalies such as double ureters, are all candidates for early endoscopic treatment as the likelihood for spontaneous resolution is very small in these patients. Open surgery may be reserved for use only in the 5-10% of patients not responding to endoscopic treatment, and in patients with severe ureteral anomalies. With the improvement of the injection techniques described in this chapter, the results of endoscopic treatment can be expected to improve significantly.