Is routine voiding cystourethrogram necessary following double hit for primary vesicoureteral reflux?

Long-term clinical success following Double HIT for the endoscopic correction of primary VUR is high, and the majority of children avoid additional procedures. Unless indicated by high-grade, young age, clinical failure, or family/surgeon preference, consideration should be given to making postoperative VCUG an option rather than a recommendation in children undergoing endoscopic treatment of primary VUR using the Double HIT method.194Figure. Flowchart demonstrating the clinical and radiographic success of patients according to postoperative VCUG status. “Indicated” VCUGs include those for grade 4-5 VUR, those in children less than 2 years of age, and those obtained for a postoperative fUTI.