COMPARISON OF ENDOSCOPIC AND SURGICAL TREATMENT OF VESICOURETERAL REFLUX IN CHILDREN

Abstract

Aim of the study: The aim of this study is to compare the endoscopic and surgical methods for treating vesicoureteral reflux in children treated at the Pediatric Surgery Clinic in Split, focusing on their prevalence, treatment success rate, length of hospitalization, and use of analgesics. The obtained data were compared with findings from recent literature.

Materials and methods: Data were collected by reviewing the archives of the Department of Pediatric Surgery, University Hospital Center Split, for the period from 2017 to 2024. Patient data, based on their health characteristics, were presented in tables and graphs using absolute and relative frequencies. Numerical variables were analyzed using descriptive statistics, including medians, interquartile ranges, and total ranges, while the normality of distribution was tested with the Kolmogorov-Smirnov test. The Chisquare test was used for statistical analysis, and when its assumptions were not met, Fisher’s exact test was applied. Additionally, numerical variables were compared using the Mann-Whitney U test. The level of statistical significance was set at 5% (p<0.05).
Statistical analysis was conducted using the software STATISTICA 13 (Tibco, California, USA).

Results: Endoscopic treatment of VUR was found to be 3.22 times more frequent than surgical treatment. The median hospital stay for children treated with the endoscopic method was 1 day, compared to 3 days for those treated with the classical surgical approach (p<0.001). The majority of surgical procedures involved extravesical the Lich-Gregoir type techniques. Extravesical surgical procedures were 5.62 times more common than intravesical treatment methods (p<0.001). Analgesics were administered to all children undergoing surgical treatment, with their use being 5.7 times more frequent compared to children treated endoscopically
(p<0.001). The success rate of endoscopic treatment was 80.55%, while the success rate of surgical treatment on the first attempt was 96.22%.

Conclusion: The obtained results are consistent with expectations , and the success rates of the methods used for treating vesicoureteral reflux at the Pediatric Surgery Clinic are comparable with findings reported in recent global literature.