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.