Purpose: Vesicoureteral Reflux (VUR) is the most common urologic condition in pediatric population, affecting almost 1% of children. The present study aims to compare outcomes of an open surgical technique (Gil-Vernet), an old-fashioned method still performed in some centers, and the endoscopic correction using Vantris as a preferred less invasive method in children with VUR.

Materials and methods: In this randomized clinical trial, a total of 61 children with VUR of grades I-IV underwent either open surgical repair using the Gil-Vernet approach (30 patients, 50 renal refluxing units), or endoscopic repair using Vantris as the bulking agent (31 patients, 49 renal refluxing units). The change in VUR grade before and after operation was compared between the two groups.

Results: The Vantris group comprised 5 males and 26 females with the mean age of 6.15±2.26 years (range, 1-10) versus the Gil-Vernet that included 9 males and 21 females with the mean age of 5.23±2.05 years (range, 1-10) (p=0.20 and 0.21, respectively). The VUR grade decreased significantly in both groups after operation (p<0.001), but despite a better improvement in the Vantris patients the inter-group analysis missed a statistically significant level in a marginal fashion (p=0.07). The rate of improvement and full improvement was 98% and 81.6% in the Vantris group vs. 94% and 86% in the Gil-Vernet group, respectively (p=0.62 and 0.56, respectively).

Conclusion: Although postoperative improvement in VUR grade was better in the Vantris® group than that in the Gil-Vernet group, the difference was not statistically significant. Both methods of treatment were safe and with a high rate of success. Nevertheless, lesser manipulations performed in Vantris® makes it favorable comparing with open Gil-Vernet method.