Conclusions
As a conclusion current trends in management of reflux in our country do not yet follow the EAU guidelines on VUR in low and moderate risk groups. This might be due to several factors including parental preference, cultural attitudes, surgical expertise and approach of different pediatric urology clinics. As expected there is an increased tendency for initial surgical treatment in high risk groups in accordance with the EAU guidelines. The overall success rate could be low due to variability between clinics and reference of complex cases to the tertiary centers as well as inclusion of endoscopic surgery and increased preference of surgical treatments as initial method in the high risk group after 2013 as high risk disease is high grade reflux (grade 4-5) that is usually treated with UNC and more technically demanding compared to UNC’s done for lower grades of reflux.