CYSTOSCOPIC ASSESSMENT OF THE URETERAL ORIFICE AND CHOICE OF ENDOSCOPIC INJECTION TECHNIQUE IN CHILDREN WITH PRIMARY HIGH-GRADE VESICOURETERAL REFLUX

Endoscopic subureteric injection of bulking agents is widely used as a minimally invasive alternative to ureteral reimplantation in children with vesicoureteral reflux (VUR). However, in grade IV–V reflux its results are less predictable, and success after a single injection varies considerably between centres [1]. Anatomical features of the ureterovesical junction visible at cystoscopy, including orifice configuration and hydrodistention, as well as the injection technique itself, are considered possible determinants of outcome, but their prognostic value remains debated [2, 3].