Surgical management of vesicoureteral reflux in children

Vesicoureteral reflux is an anatomical and functional pathology of the upper urinary tract resulting in retrograde flow of urine from the bladder into the ureter. The prevalence of this pathology is approximately 1% of all children. The main goals in the treatment of vesicoureteral reflux are to preserve renal function and minimise the risk of pyelonephritis. Although endoscopic treatment of PMR has become a priority in recent decades, its effectiveness in high-grade reflux is rather low. Therefore, surgical correction remains the main treatment for high-grade reflux. Most surgeons disagree on the choice of a universal surgical technique for the treatment of vesicoureteral reflux. This review presents the most commonly used ureterocystostomies in children with modifications: Lich-Gregoir, Cohen, Glenn-Anderson and Politano-Leadbetter. The prospects of treating reflux megaureter using modifications of the Bischof technique are also analysed.