Trends in the surgical management of vesicoureteral reflux in Finland in 2004-2014

Abstract

<p>Objectives: Previous data on the trends of surgical treatment of vesicoureteral reflux outside USA are<br>scarce. The aim of this study was to clarify the national trends of operative treatment of vesicoureteral<br>reflux (VUR) in Finland.<br>Methods: We analyzed national data from Finnish Care Register for Health Care on children (<16 years<br>of age) surgically treated for VUR in 2004–2014.<br>Results: Endoscopic injections of the ureteral orifices were primarily performed for 1212 and open<br>ureteral reimplantation for 272 children. The use of both types of surgery decreased during the study<br>period (p=0.0043 and p<0.001, respectively). The median age at surgery for VUR was lower in those<br>treated with open ureteral reimplantation than those with endoscopic injections of the ureteral orifices<br>[3 and 4 years, respectively] (p=0.0001). The length of hospital stay was significantly longer (median<br>9.9 days) with open ureteral reimplantation compared to that (median 1.3 days) with endoscopic injections<br>(p<0.0001) and did not change during the study period. Reoperations were significantly more<br>common in patients who were primarily treated with endoscopic injections (n=146/1072, 14%) than<br>with ureteral reimplantation (n=7/230, 3%) (p<0.0001).<br>Conclusions: While the best treatment options for VUR remain debatable, operative treatment of VUR<br>has become less common in Finland.<br></p>