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JOURNAL OF UROLOGICAL SURGERY, vol.12, no.4, pp.219-225, 2025 (ESCI, TRDizin)
Objective: We aimed to compare endoscopic subureteric injection with conventional open ureteral reimplantation in vesicoureteral reflux disease (VUR) in terms of long-term postoperative quality of life (QoL) to find potential factors that would predict the psychological outcome. Materials and Methods: This retrospective cohort was based on data from February 2016-December 2019 on 115 children and adolescents (4-18 years old) who underwent elective surgery due to VUR disease and were hospitalized thereafter. Patients were divided into two groups according to the surgery they underwent, "endoscopic subureteral hyaluronic acid/dextranomer copolymer injection" (n=65), and "open ureteroneocystostomy" (n=50). With their mothers, the patients filled out the Pediatric QoL Questionnaire (PedsQL) remotely 2 to 6 years post-surgery (median 49 months), and the postoperative QoL was compared among the patients with regard to the QoL. Those with congenital or concomitant diseases were excluded. Results: In VUR, patients undergoing either type of surgery had similar scores in all domains in PedsQL. In other words, postoperative QoL levels did not differ between endoscopic treatment and conventional open ureteral reimplantation. Furthermore, linear regression analysis identified maternal higher education level as the only significant predictor of higher postoperative QoL (estimate: 10.89; 95% confidence interval: 1.54-20.23; p=0.023). Conversely, factors such as surgery type, length of hospital stay, previous surgical experience, and patients' age at the time of the survey were not associated with postoperative long-term QoL. Conclusion: The less invasive surgical modalities of VUR in the pediatric age group do not provide a significant advantage over open surgeries regarding the long-term postoperative QoL.