Pediatric surgery international
September 10, 2026 · via Europe PMC
Preoperative predictors for endoscopic Deflux injection therapy for vesicoureteral reflux: a single-center experience during 10 years.
Ikegami M, Nakazawa-Tanaka N, Nojiri S, +5 more, Okazaki T.
AI summary — for doctors, generated from the abstract only
In a 10-year single-center study of 109 children with vesicoureteral reflux treated with endoscopic Deflux injection, constipation was an independent predictor of treatment failure even after accounting for other bladder/bowel dysfunction, suggesting it could serve as an easily assessed clinical marker for risk.
What was studied
A retrospective single-center study of 109 patients (173 renal units) with primary vesicoureteral reflux (VUR) treated with endoscopic Deflux injection (EDI) over 10 years, using univariable and multivariable analysis to identify preoperative predictors of correction failure after the first injection and after up to three injections.
Key findings
- VUR was corrected in 86 of 173 units (49.7%) after the first injection and in 152 units (87.9%) after up to three injections.
- High-grade VUR, renal scarring, and constipation were associated with failure after the first injection on univariable analysis; only constipation remained associated with failure after up to three injections.
- Multivariable analysis identified high-grade VUR, renal scarring, and constipation as independent risk factors for first-injection failure.
- These associations, particularly for constipation, persisted even after excluding patients with clinically evident bladder and bowel dysfunction.
Clinical relevance
The findings suggest that screening for and addressing constipation before or alongside endoscopic Deflux injection could be a simple, clinically useful step to help identify children at higher risk of treatment failure, especially young children in whom bladder function is harder to assess.
Who should care
Limitations
This was a retrospective single-center study, and while constipation's association persisted after excluding clinically evident bladder/bowel dysfunction, the study cannot fully exclude milder or undetected forms of such dysfunction as a confounding factor.
Constipation appears to independently predict failure of endoscopic injection treatment for vesicoureteral reflux in children, suggesting it's a simple marker clinicians could use to flag higher-risk patients.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Purpose
We conducted an analysis to identify preoperative predictors of vesicoureteral reflux (VUR) correction following endoscopic Deflux injection (EDI).
Methods
We retrospectively reviewed 109 patients with primary VUR (173 renal units) aged < 16 years who underwent EDI between 2016 and 2025. If grade II-V VUR persisted on postoperative voiding cystoureterography, injections were repeated up to two additional times. Preoperative variables included constipation, renal scarring, and VUR grade.
Results
VUR was corrected in 86 units (49.7%) after the first injection and in 152 (87.9%) after up to three injections. Univariable analysis showed that high-grade VUR, renal scarring, and constipation were associated with failure after the first injection, whereas only constipation was associated with failure after up to three injections. Multivariable analysis identified high-grade VUR, renal scarring and constipation as independent risk factors for failure of the first injection. These associations persisted even after exclusion of clinically evident bladder and bowel dysfunction (BBD).
Conclusions
Constipation was an independent risk factor for failure after the first injection and remained associated with failure after repeated injections, even after exclusion of clinically evident BBD. It may serve as a clinically relevant and easily assessable predictor, particularly in young children in whom bladder function is difficult to assess.
DOI
10.1007/s00383-026-06629-7
PMID
42720685
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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