Objective: The aim of this study is to evaluate the clinical outcomes and determine factors influencing success rates in pediatric patients undergoing either endoscopic injection or open surgical interventions for vesicoureteral reflux. Materials and methods: This retrospective study included 286 pediatric patients (443 ureters) treated for VUR. Patients underwent either endoscopic subureteric injection (STING) or ureteroneocystostomy (UNC). Clinical, radiologic, and surgical parameters were evaluated. Comparative analysis was done based on the final surgery and its outcomes. A binary logistic regression analysis was conducted to develop a treatment failure model.
Results: A total of 286 pediatric patients (443 ureters) treated for VUR were included in this retrospective analysis. Endoscopic STING was performed in 278 patients (431 ureters), achieving a success rate of 83%. Eight patients (12 ureters) underwent primary UNC, all of which were successful (100%). Patients who required secondary UNC following failed STING had a 92% success rate (67/73 ureters). Renal scarring was detected in 54% of right and 69.1% of left kidneys. Logistic regression identified age (OR=1.2; p=0.048), male sex (OR=2.5; p=0.037), and high-grade VUR (Grade 3 vs. 5: OR=5.3, p=0.003) as significant predictors of failure following STING. Overall, the total treatment success rate across all interventions was 98.9%.
Conclusions: Younger age, male gender, and higher VUR grade were independent predictors of STING failure.
Keywords: Vesicoureteral reflux, children, endoscopic injection, ureteroneocystostomy
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