As a preoperative definite diagnosis, the extent of reflux should be evaluated by voiding cystourethrography (VCUG) and international vesicoureteral reflux (VUR) grading system. The functional evaluation also should be done by 99mTc-DMSA scintigraphy. In addition, such other examinations as ultrasonography, intravenous pyelography (IVP), CT, and MRI should be performed for evaluation of associated anomalies. As a first step of treatment, conservative therapy with prophylaxis antibiotics is initially introduced, and some cases can be managed. Some cases with breakthrough infection or findings of developing renal dysfunction should be treated by any kind of surgical intervention including endoscopic treatment and open surgery.
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