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Vesicoureteral reflux in infants
1Department of Pediatric Surgery, Sahlgrenska University Hospital Ostra, Gothenburg, Sweden.
Pediatric Nephrology (Berlin, Germany)
|August 24, 1999
Summary
High-grade vesicoureteral reflux (VUR) in infants differs significantly between males and females. Male infants often show hypercontractile bladder patterns, while females exhibit high capacity, suggesting sex-specific management for VUR.
Area of Science:
- Pediatric Urology
- Nephrology
- Developmental Biology
Background:
- Grade 5 vesicoureteral reflux (VUR) is predominantly observed in male infants, often associated with renal damage.
- In females, high-grade VUR is rare, with typically less severe, focal kidney damage.
Purpose of the Study:
- To investigate sex-based differences in bladder function and pathogenesis of VUR in infants.
- To evaluate the spontaneous resolution rates of VUR and inform treatment timing.
Main Methods:
- Urodynamic studies and free voiding assessments were used to analyze bladder function in male and female infants with VUR.
- Retrospective analysis of prenatally diagnosed VUR cases to determine resolution rates.
Main Results:
- Male infants with dilating reflux often present with hypercontractile bladders, progressing to high-capacity, underfilling bladders.
- Female infants rarely show hypercontractility; they typically have high-capacity bladders with increased residual urine.
- A significant spontaneous resolution rate (40%) of grades 4 and 5 VUR was observed in the first two years for prenatally diagnosed cases.
Conclusions:
- Infant VUR exhibits distinct urodynamic patterns and potential pathogenetic differences between sexes.
- Delayed surgical intervention for VUR in infants may be warranted due to high spontaneous resolution rates.