Endoscopic treatment of vesicoureteral reflux: Changing trends over the years

Objective: To investigate factors affecting the success rate of endoscopic subureteral injection (ESI) in patients with vesicoureteral reflux (VUR) and to evaluate the changes in years. Materials and Methods: A total of 439 patients with primary VUR who underwent ESI were included. We used dextranomer hyaluronic acid copolymer (Dx-HA) as bulking agent. Statistical analyzes were performed by SPSS 20.0 programme. Results: Overall patient-based and renal unit-based success rates of ESI were 75.6% and 78.2%, respectively. Operational age of 82 months and lower grades of VUR were found to be the factors increasing success rate (p=0.023, p=0.005). Success rates were as 83.6%, 77.9% and 64.5% for grades of reflux 1-2, 3 and 4-5, respectively (p=0.002). When patients were seperated into four equal chronological groups, we observed that the ratio of patients who had previous failed ESI, high-grade reflux and renal scarring and volume of injected material has increased over the years. Conclusion: ESI has higher success rates in older children and lower grades (grades 1-3) of VUR. It is performed also in high-grade patients with acceptable success rates which tended to increase over the years.