SURGICAL TREATMENT OF PRIMARY HIGH-GRADE VESICOURETERAL REFLUX IN CHILDREN: COMPARATIVE OUTCOMES OF ENDOSCOPIC, PNEUMOVESICOSCOPIC AND OPEN TECHNIQUES

Primary vesicoureteral reflux (VUR) accounts for up to 30% of urinary tract anomalies in children, and its high grades (IV–V) remain a leading cause of recurrent pyelonephritis, renal scarring and reflux nephropathy. Reported success of endoscopic subureteric injection in high-grade VUR varies widely and is lower than that of ureteral reimplantation, while open surgery is more invasive and requires longer hospital stay [1, 2]. The choice of operation is still based mainly on the voiding cystourethrography grade, whereas the morphology of the ureterovesical junction and renal function are rarely taken into account in a structured way.