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Vesicoureteral reflux: why we can't agree on its management! An evidence based approach

Delphine Demède1, Pierre Mouriquand

  • 1Department of Paediatric Urology. Hôpital Debrousse, Lyon, France. delphine.demede@chu-lyon.fr

Archivos Espanoles De Urologia
|May 22, 2008
PubMed

Insights

Vesicoureteral reflux (VUR) management lacks strong evidence, with many beliefs based on low-quality studies. Evidence-Based Medicine (EBM) highlights the need for better data to guide VUR diagnosis and treatment.

Area of Science:

  • Pediatric Urology
  • Evidence-Based Medicine

Background:

  • Vesicoureteral reflux (VUR) is a complex pediatric urological condition with extensive literature.
  • Understanding VUR and its management is challenging due to numerous publications.

Purpose of the Study:

  • To clarify diagnostic and treatment approaches for VUR using Evidence-Based Medicine (EBM).
  • To assess the quality of evidence supporting current VUR management strategies.

Main Methods:

  • A comprehensive literature review of 6,715 publications on "vesicoureteral reflux" and "vesicoureteric reflux" was performed.
  • Articles were critically reviewed and graded using EBM scoring based on methodological design.

Main Results:

  • Most current beliefs regarding VUR are founded on low-evidence publications.
  • EBM currently lacks sufficient data to establish definitive recommendations for VUR diagnosis and treatment.
  • Antenatal urinary tract dilation and symptomatic UTIs warrant investigation for VUR.

Conclusions:

  • Surgery for VUR should be considered for recurrent UTIs or worsening renal function.
  • There is no consensus on managing persistent asymptomatic VUR, antibiotic prophylaxis, or surgical treatment choices.

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