Surgical Interventions for Pediatric Vesicoureteral Reflux: Outcomes and Key Predictors of Success

Vesicoureteral reflux (VUR) is the most common urinary system disorder in children and can lead to chronic kidney failure. This study aims to evaluate the effectiveness of endoscopic and surgical treatments for VUR in pediatric patients. We retrospectively reviewed data from children who underwent surgical treatment for VUR between January 2010 and December 2019 at Sami Ulus Obstetrics and Gynecology, Pediatrics, Health Practice, and Research Center. A total of 157 patients (113 girls, 44 boys) were included. The success rate of the first STING was 31.8% for 0–6 years, 43.9% for 6–12 years, and 75% for 12–18 years. Success was 46% for low/moderate reflux and 24.5% for high-grade reflux. Overall, the first STING success rate was 38.6%, increasing to 59.5% with multiple injections. Females had a higher history of preoperative UTIs (p = 0.006) and a higher rate of low-grade reflux (p = 0.023). The success rate was significantly higher in the 12-18 years group (p = 0.032) and lower in high-grade reflux (p = 0.015). Girls had a significantly higher rate of postoperative UTIs (p = 0.0001). Surgical success in pediatric VUR is influenced by age and reflux grade, with better outcomes in older children and those with low/moderate reflux. Given the lower efficacy of STING in high-grade VUR, open surgery may be a preferable option in these cases. Higher postoperative UTI rates in girls suggest a need for closer follow-up and potential prophylaxis adjustments. Tailored treatment based on individual risk factors may improve outcomes.