Cystoscopic subureteral injection in children with vesicoureteral Reflux

Vesicoureteral reflux is one of the major cause of end-stage renal disease in children in our country. Febrile UTI with should be treated immediately to prevent renal damage. Due to recent developments in endoscopic techniques, there has been a remarkable change in the treatment protocols of VUR in children, and minimally invasive interventions have gained popularity. Therefore, cystoscopic subureteral injection has become to replace medical treatment as well as ureteroneocystostomy. So in most of the children, VUR now can be easily, and successfully treated on an outpatient basis, and thus avoiding need for proscribing prophylactic antibiotics for years and serial invasive follow-up exams. Many different materials have been used for cystoscopic injections. All have increased short-term success rates. Cystoscopic subureteral injections have marked benefits in selected cases including young babies with high grade VURs. Long-lasting stable materials that do not disappear with time should be selected. Its main disadvantages include lower success rates when compared with ureteroneocystostomy, and the requirement of confirmation of resolution of VUR based on postoperative VCUG. Though rarely obstructions may develop due to prolonged retention of subureteral injection material. Contralateral reflux may be observed after injection. In addition, sufficient evidence-based data related to its long-term effects are not still available. 2017 © Logos Medical Publishing. All Rights Reserved.