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Minimally Invasive Management of Urinary Reflux

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The SAGES Manual of Pediatric Minimally Invasive Surgery

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Abstract

Vesicoureteral reflux (VUR) is the retrograde flow of urine from the bladder to the upper urinary tract and is common, occurring in 30–70 % in children with urinary tract infections. While reflux is not typically harmful in the absence of bacterial contamination or high bladder pressures, children with reflux and bacteriuria are at a much higher risk for pyelonephritis. Repeat episodes of pyelonephritis have been linked to acquired renal scarring, hypertension, renal dysplasia, and progressive renal failure, highlighting the importance of diagnosis and treatment in the affected pediatric population. Minimally invasive techniques to address VUR include robotic-assisted laparoscopic extravesical or intravesical ureteral reimplantation and endoscopic antireflux surgery with injection of Deflux®. These techniques offer success rates approaching, though not yet exceeding, the standard open ureteral reimplantation surgery but are associated with advantages such as improved cosmesis, shortened hospitalization, and decreased need for postoperative analgesics.

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Author information

Authors and Affiliations

  1. Urology, Yale–New Haven Hospital, Yale University School of Medicine, 20 York St., New Haven, CT, 06510, USA

    Charlotte Wu

  2. Urology and Pediatrics, Children’s National Medical Center, 111 Michigan Ave., NW, West Wing 4th Floor, Washington, DC, 20010, USA

    Hans G. Pohl

Authors
  1. Charlotte Wu
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  2. Hans G. Pohl
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Correspondence to Charlotte Wu or Hans G. Pohl .

Editor information

Editors and Affiliations

  1. Division of Pediatric Surgery, East Carolina University Brody School of Medicine, Greenville, North Carolina, USA

    Danielle S. Walsh

  2. Northeast Ohio Medical College Division of Pediatric Surgery, Akron Children’s Hospital, Akron, Ohio, USA

    Todd A. Ponsky

  3. Division of Pediatric Surgery, Akron Children’s Hospital, Akron, Ohio, USA

    Nicholas E. Bruns

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Wu, C., Pohl, H.G. (2017). Minimally Invasive Management of Urinary Reflux. In: Walsh, D., Ponsky, T., Bruns, N. (eds) The SAGES Manual of Pediatric Minimally Invasive Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-43642-5_51

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  • DOI: https://doi.org/10.1007/978-3-319-43642-5_51

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-43640-1

  • Online ISBN: 978-3-319-43642-5

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