title: Secondary surgery for vesicoureteral reflux after failed endoscopic injection: Comparison to primary surgery.
abstract: OBJECTIVE
  As endoscopic treatment for vesicoureteral reflux (VUR) has increased, secondary ureteral reimplantation (UR) after failure of endoscopic treatment has increased. We studied the clinical feature and efficacy of secondary UR after failure of endoscopic treatment compared with primary UR.
  
  
  METHODS
  Eighty-one children who had UR for VUR were enrolled. Charts were reviewed retrospectively for age, sex, grade of VUR before surgery, operative time, hospitalization period, postoperative complication, and success rate. Primary UR (group A, n=64) was compared with secondary UR after failed endoscopic treatment (group B, n=17). In group B, telephone survey for the satisfaction of endoscopic treatment and surgery was done.
  
  
  RESULTS
  Mean age of each group was 49.6±37.1 and 56.6±22.5 months (p=0.236). There was no significant difference between each group in sex, mean operative time, postoperative transfusion, complication rate, and success rate. As telephone survey in group B, eleven responders preferred endoscopic treatment as primary treatment of VUR because it was a simple method and no hospitalization.
  
  
  CONCLUSIONS
  Secondary UR after failure of endoscopic treatment was similar to primary UR. Parents preferred endoscopic treatment as first line treatment for VUR in spite of the need for secondary UR after failure of endoscopic treatment.
authors.affiliation: Department of Urology, Pusan National University Yangsan Hospital, Yangsan, Korea.
authors.forename: Seungsoo
authors.initials: S
authors.lastname: Lee
authors.affiliation: Department of Urology, Pusan National University Yangsan Hospital, Yangsan, Korea.
authors.forename: Seung Chan
authors.initials: SC
authors.lastname: Jeong
authors.affiliation: Department of Urology, Pusan National University Yangsan Hospital, Yangsan, Korea.
authors.forename: Jae Min
authors.initials: JM
authors.lastname: Chung
authors.affiliation: Department of Urology, Pusan National University Yangsan Hospital, Yangsan, Korea.
authors.forename: Sang Don
authors.initials: SD
authors.lastname: Lee
mesh_terms: D001294:Attitude to Health; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007267:Injections; D007432:Intraoperative Period; D008297:Male; D010290:Parents / Q000523:psychology; D012086:Reoperation / Q000379:methods; D012092:Replantation / Q000009:adverse effects / Q000379:methods; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014513:Ureter / Q000601:surgery*; D018666:Ureteroscopy / Q000379:methods*; D014718:Vesico-Ureteral Reflux / Q000601:surgery*
keywords: Replantation; Ureter; Vesicoureteral reflux