MANAGEMENT OF RECURRENT VESICOURETERAL REFLUX AFTER URETERAL REIMPLANTATION IN CHILDREN: A COMPREHENSIVE LITERATURE REVIEW
Keywords:
vesico-ureteral reflux, endoscopic correction, ureteral reimplantation, bulking agentAbstract
Vesicoureteral reflux (VUR) is a prevalent pediatric urological condition, often leading to significant morbidity, including recurrent urinary tract infections (UTIs) and progressive renal scarring. While primary ureteral reimplantation boasts high success rates, a considerable number of children experience persistent or recurrent VUR, or develop new complications such as ureteral obstruction, necessitating further intervention. This comprehensive review synthesizes evidence, delineating the incidence, multifactorial causes, and diverse management strategies for VUR following initial surgical failure. Emphasis is placed on both less invasive endoscopic corrections utilizing bulking agents and various reoperative approaches, including open, laparoscopic, and robotic-assisted techniques. The review examines their reported efficacies, technical considerations, influencing factors for success, and associated complications, concluding with an individualized approach to care that prioritizes bladder function assessment.
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