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Spontaneous resolution of high grade infantile vesicoureteral reflux

Sofia Sjöström1, Ulla Sillén, Marc Bachelard

  • 1Pediatric Uro-Nephrologic Centre, Queen Silvia Children's Hospital, Gothenburg, Sweden. sofia.sjostrom@vgregion.se

The Journal of Urology
|July 13, 2004
PubMed

Insights

High-grade vesicoureteral reflux (VUR) in infants shows a 39% overall spontaneous resolution rate. Boys diagnosed in their first year have a higher resolution rate, while recurrent UTIs and bladder dysfunction hinder VUR resolution.

Area of Science:

  • Pediatric Urology
  • Nephrology

Background:

  • Vesicoureteral reflux (VUR) is a common condition in infants, often leading to recurrent urinary tract infections (UTIs) and potential kidney damage.
  • High-grade VUR (grades III-V) presents a significant clinical challenge due to its association with poorer outcomes.

Purpose of the Study:

  • To determine the spontaneous resolution rate of high-grade VUR in infants.
  • To evaluate the impact of gender, diagnosis timing, recurrent UTIs, and bladder dysfunction on VUR resolution.

Main Methods:

  • Prospective study of 115 infants (grades III-V VUR) with a median follow-up of 39 months.
  • Utilized video cystometry and noninvasive voiding observations for patient monitoring.
  • Analyzed data based on gender, prenatal/postnatal diagnosis, and presence of UTIs or bladder dysfunction.

Main Results:

  • Overall spontaneous resolution rate was 39%. Boys showed a higher resolution rate for grades IV-V VUR during the infant year.
  • Recurrent UTIs (47% of cases) and bladder dysfunction (37% of patients) were significantly correlated with VUR nonresolution.
  • No significant difference in resolution was observed based on diagnosis timing (prenatal vs. postnatal).

Conclusions:

  • High-grade congenital VUR has a notable spontaneous resolution rate, particularly in boys within the first year of life.
  • Recurrent UTIs and bladder dysfunction are identified as negative prognostic factors for VUR resolution.
  • These findings underscore the importance of monitoring and managing associated factors for improved VUR management in infants.
Abstract

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