Antireflux surgery in infants with vesicoureteral reflux

Febrile urinary tract infections (UTI) resulted in the admission of five infants (four boys, one girl) to Okinawa Prefectural Hospital in Miyako. The first febrile episode developed at an average age of 1.3 months. All patients underwent cystoscopy and X-ray studies to role out secondary causes for vesicoureteral reflux (VUR). All patients had high grade reflux and underwent antireflux surgery using a modification of the Amar-Paquin method or the Politano-Leadbetter method. They tolerated the procedures without any complications. No UTI recurred and VUR disappeared in one year following surgery. Early surgical intervention seems beneficial for selected infants with high grade VUR, but the surgical procedure and methods for infants, especially those with severe dilated ureter, are still controversial.