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a clinical pearl Operative indications in VUR

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Quote from "ESPES Manual of Pediatric Minimally Invasive Surgery" by Ciro Esposito, François Becmeur, Henri Steyaert, Philipp Szavay -

"According to recommendations from the European Association of Urology and the American Urological Association, we decided to operate on children with VUR grade III or more, with renal dysfunction (DMSA < 40%) or renal scarring demonstrated on isotope renography, and children developing recurrent pyelonephritis despite optimal medical treatment."
 
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