Factores condicionantes de éxito o fracaso del tratamiento endoscópico en el reflujo vesicoureteral primario pediátrico:: una revisión sistemática

OBJECTIVE: The objective of this paper is identifying the factors that may condition the success or failure of endoscopic therapy for vesicoureteral reflux in the paediatric population. MATERIAL AND METHODS: A bibliographic review was performed in the Cochrane Library and PUBMED of all the studies which the principal subject was about identifying factors involved in the success or failure of endoscopic therapy for vesicoureteral reflux in the pae- diatric population. RESULTS: Of a total of 1410 studies, 14 studies and 17 factors potentially involved in the success or failure of endoscopic therapy were fully analysed according to the different studies reviewed. After analyzing these studies, we identified that the most widely accepted factors that determine the success or failure of endoscopic therapy are the high degree of pre-surgical reflux, the previous injection of antireflux material, the surgical experience and the presence of dysfunction of the lower urinary tract (UTD). Other factors such as the amount of bulking substance used, meatal morphology, renal damage and age at the time of injection could be potentially involved. The technique used and the bulking material do not seem to be associated with the response to therapy. Exists a great heterogeneity of the reviewed studies, both in relation to the characteristics of the patients included, criteria and surgical technique and evaluation of results. CONCLUSIONS: The degree of pre-surgical reflux, the presence of UTD, previous injections and surgical expe- rience are the most widely accepted determining factors in the results of endoscopic therapy according to the different studies published in this topic.