What is the role of open surgery?

Open surgery is an option for severe cases of VUR

It can be used for high-grade unilateral or bilateral VUR

The open surgical repair of vesicoureteral reflux (VUR) is most commonly used in grades IV and V VUR.1

What do children experience with open surgery?

  • Prolonged hospital stay2
  • Post-operative pain or discomfort2
  • Possible complications such as bleeding, blockages of the ureters, bladder issues1

Considerations of Deflux versus open surgery

  • Deflux is the preferred and most often used treatment among providers in academic settings for long-term cure of reflux.3
  • VUR correction with Deflux is generally a 15-minute outpatient procedure requiring short-acting general anesthesia versus a lengthier inpatient procedure requiring general anesthesia4
  • The procedure is considered minimally invasive with minimal post-operative pain and no need for urinary catheter5
  • Children can usually return to school or normal activities the day after the procedure versus a surgical reimplant that generally requires hospitalization for post-operative pain and temporary urinary catheter drainage.5

References:

  1. Capozza N, Lais A, Matarazzo E, Nappo S, Patricolo M, Caione P. Treatment of vesicoureteric reflux: a new algorithm based on parental preference. BJU Int. 2003;92(3):285-288.
  2. Ogan K, Pohl HG, Carlson D, Belman AB, Rushton HG. Parental preferences in the management of vesicoureteral reflux. J Urol. 2001;166(1):240-243.
  3. Osumah T, Gearman D, Ahmed M, et al. Preference and use of minimally-invasive techniques in vesicoureteral reflux: correlating a crowdsourced survey and American board of urology case logs. J Urol. 2019;201(4S):e945.
  4. Cerwinka WH, Scherz HC, Kirsch AJ. Endoscopic treatment of vesicoureteral reflux with dextranomer/hyaluronic acid in children. Advances in Urology. 2008; 1-7.
  5. Sung J, Skoog S. Surgical management of vesicoureteral reflux in children. Pediatr Nephrol. 2012;27:551-561.