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There is a difference in median increased bladder capacity when a segment of distal ureter is used to augment the bladder versus 1 or 2 whole ureters. However, the use of distal ureter still represents a safe alternative for augmenting the bladder and simultaneously resolving massive reflux. Ureterocystoplasty is an excellent choice for increasing bladder capacity and improving bladder compliance despite the different amounts of tissue available.

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Vesicoureteral reflux (VUR) is a disorder that has been studied since the early days of pediatric urology. From 1893, when it was first documented in humans by Pozzi, the research and clinical management of VUR has been marked by pendulum swings through the decades. Initially, the vesicoureteral junction was the main subject of study, whereas current practice takes into account the bladder and bowel dynamics. The primary objective, however, is unchanged: preservation of the kidney and its function. Management of the condition has included open surgery, minimally invasive surgery, endoscopic treatment, antibiotic prophylaxis, and watchful waiting. In this article, we will attempt to cover every angle of this complex pathology and its current management in children.

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