title: [Surgical treatment of vesicourethral reflux in paediatric population].
abstract: BACKGROUND
  Early diagnosis and adequate follow-up are fundamental principals for the treatment of vesicourethral reflux in children. The treatment options in these cases remain an individual choice based on multiple factors.
  
  
  OBJECTIVE
  To determine and compare the effectiveness of two different surgical techniques (endoscopic and conventional) used on vesicourethral reflux treatment.
  
  
  METHODS
  Cohort study, based on the clinical files of children and adolescents submitted to surgical treatment of vesicourethral reflux, between the 1st January of 2000 and 30th April 2006. The study included one year period of follow-up. Multiple variables with a presumable influence on the therapeutic option were analysed. In cases of surgical treatment, effectiveness and safety of the surgical technique where determined.
  
  
  RESULTS
  Included 46 children and adolescents, in a total of 68 refluxive units. Thirty seven of all renal units, where submitted to endoscopic treatment: the success rate with one injection of Deflux® was 62% (IC 95% [0.46; 0.78]), increasing for 78% (IC 95% [0.65; 0.91]) when the second injection was performed. Thirty seven renal units were submitted to open surgery: Cohen procedure in 21 patients and nefrourethrectomy in two cases. Excluding the nefrourethrectomy, the classical surgery had a success rate of 97% (IC 95% [0.91; 1]). The reason between probabilities of success, considering endoscopic surgery vs. conventional surgery was 0,8 (IC 95% [0.68; 0.97]). Registered thirteen complications, most of them (85%) after conventional surgery.
  
  
  CONCLUSIONS
  The high complication rates determined for conventional surgery could justify the frequent option for endoscopic surgery in small centres, despite its lower success rates.
  
  
  CONCLUSIONS
  This study confirms that this therapeutic option establishes a good commitment between prophylaxis safety and classical surgery effectiveness.
authors: Serviço de Pediatria, Hospital Pedro Hispano, Matosinhos, Portugal.
authors: Ana
authors: A
authors: Aguiar
authors: André
authors: A
authors: Cardoso
authors: Rui
authors: R
authors: Prisco
authors: Maria Eduarda
authors: ME
authors: Cruz
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies; D018666:Ureteroscopy; D013520:Urologic Surgical Procedures / Q000379:methods; D014718:Vesico-Ureteral Reflux / Q000601:surgery*