The effectiveness of endoscopic management of vesicoureteral reflux among pediatric patients in Palestinian hospitals: a retrospective cohort study

Abstract

Abstract Background To reveal the effectiveness of endoscopic materials that are used in the Palestinian hospitals as a treatment method of vesicoureteral reflux (VUR) discussing the success rate, advantages, complications and prognosis of the procedure among pediatric age group. Methods We retrospectively reviewed the electronic medical records for each Palestinian pediatric patient aged less than 16 years old who were diagnosed with VUR in the last 5 years and treated by bulking agent as the main treatment, looking into their medical notes, tests results, imaging studies reports especially the Pre-operative investigation of DMSA and VCUG, in addition to Ultra sonogram and VCUG were needed to be performed post operatively 1 and 3 months respectively, we also searched for the way they were treated by, who was fully recovered and who had complications afterword, excluding the patients with renal scarring or renal disease due to other causes except VUR.The files were recruited by convenient sampling technique, the success rate of the procedure, recurrence and complications for the overall patients was calculated. The Statistical Product and Service Solutions (SPSS) was used for data analysis in this study, participants' features were described using means, standard deviations, and percentages. Results The study included 163 pediatric patients -193 kidneys as there were 30 patients who had bilateral VUR, the median age of study participants was 4 years. There were 92 males (56.4%) and 71 females (43.6%), The affected kidney was right among 79 participants (48.4%) and left kidney among 54 participants (33.1%), 30 participants had bilateral VUR (18.4%). The procedure succeeded among 153 of units (79.3%) while it failed among 29 units (15%) and it downgraded the symptoms among 11 units (5.7%), The success rate according to the severity was 100%,100%,83%,61%16% to grade 1,2,3,4,5 respectively. Conclusion The results of our multicenter survey confirm the effectiveness and safety of subureteral single injection of non-biodegradable tissue augmenting agents in VUR correction, endoscopic therapy is now regarded as a good therapeutic option and a feasible alternative to long-term antibiotic prophylaxis; for high-grade reflux, open ureteral transplant surgeries remain the therapy of choice. Endoscopic therapy provides significant benefits for grade 3 reflux.