We did not suggest and would not agree that every patient with urinary tract infections, vesicoureteral reflux, and reflux nephropathy is a candidate for endoscopic cor-rection. Important variables include the patient’s age and sex, the duration and severity of vesico-ureteral reflux, the success of medical manage-ment, and the clinical course of the patient. The case vignette described a girl with persistent moderate vesicoureteral reflux and breakthrough pyelonephritis — a classic indication for surgical intervention.
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