Related Experiment Video

Updated: Jul 5, 2026

Vessel-sparing Excision and Primary Anastomosis
08:09

Vessel-sparing Excision and Primary Anastomosis

Published on: January 7, 2019

Predictive factors for contralateral reflux in patients with conservatively treated unilateral vesicoureteral reflux

Ubirajara Barroso1, Vivian Alvim Barroso, José de Bessa

  • 1Section of Pediatric Urology, Division of Urology, Universidade Federal da Bahia, Hospital São Rafael, and Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia, São Paulo, Brazil. ubarroso@uol.com.br

The Journal of Urology
|May 24, 2008
PubMed

Insights

In children with unilateral reflux, 21% developed new contralateral reflux. Medium to high grade reflux was a significant risk factor for this condition, impacting cure rates.

Area of Science:

  • Pediatric Urology
  • Nephrology
  • Radiology

Background:

  • Vesicoureteral reflux (VUR) is a common condition in children, characterized by the abnormal backward flow of urine from the bladder to the ureters.
  • Conservative management is often employed for VUR, but the risk of developing contralateral reflux in cases of initially unilateral VUR requires further investigation.

Purpose of the Study:

  • To determine the incidence of new contralateral reflux in children initially diagnosed with unilateral VUR and treated conservatively.
  • To identify predictive factors associated with the development of contralateral reflux.

Main Methods:

  • A retrospective analysis of 167 children diagnosed with unilateral VUR on their first voiding cystourethrogram (VCUG).
  • Exclusion of patients with bilateral or secondary VUR, or those with only one VCUG.
  • Follow-up VCUGs were performed on all included patients, with a significant number undergoing multiple examinations (3-7 VCUGs).

Main Results:

  • New contralateral reflux was observed in 21% of patients (35 out of 167) on subsequent VCUGs.
  • Medium or high grade reflux was identified as the primary risk factor for developing new contralateral reflux.
  • Spontaneous resolution of VUR occurred in 59% of children, but those who developed contralateral reflux had a lower cure rate.

Conclusions:

  • Conservative management of unilateral VUR carries a 21% risk of developing new contralateral reflux.
  • The grade of the initial reflux (medium to high) is a significant predictor of contralateral reflux development.
  • Development of contralateral reflux is associated with a decreased likelihood of spontaneous VUR resolution.
Abstract

Related Concept Videos

Gastroesophageal Reflux Disease II: Clinical Features and Management01:29

Gastroesophageal Reflux Disease II: Clinical Features and Management

Gastroesophageal reflux disease, or GERD, is a persistent medical condition that affects many individuals worldwide. Its clinical manifestations can vary greatly, making diagnosis and management challenging for healthcare professionals. The following is a comprehensive overview of the clinical manifestations, assessment, and management strategies for GERD.
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
Gastroesophageal Reflux Disease01:25

Gastroesophageal Reflux Disease

Gastroesophageal reflux disease (GERD) is the backward flow of stomach contents (acid, pepsin, or bile) into the esophagus, causing mucosal inflammation known as esophagitis. It results from failure of antireflux mechanisms, mainly the lower esophageal sphincter (LES), influenced by mechanical and physiological factors.Etiology and Risk FactorsGERD develops when LES function is weakened or when intra-abdominal pressure increases. Risk factors include aging, obesity, and sliding hiatal hernia,...
Urodynamic Studies: Uroflowmetry01:19

Urodynamic Studies: Uroflowmetry

Uroflowmetry is a non-invasive urodynamic test designed to measure various aspects of urination, including volume, flow rate, and the time to void. This test is crucial for diagnosing and assessing conditions such as bladder outlet obstruction, bladder dysfunction, incomplete bladder emptying, incontinence, and urinary tract blockages caused by benign prostatic hyperplasia (BPH) and urethral strictures.Pre-Test Instructions:Before a uroflowmetry test, patients are typically advised to drink...
Imaging Studies VI: Voiding Cystourethrography and Cystography01:22

Imaging Studies VI: Voiding Cystourethrography and Cystography

Voiding Cystourethrography (VCUG) and Cystography are specialized radiographic procedures used to examine the structure and function of the bladder and urethra.Voiding Cystourethrography (VCUG)A Voiding Cystourethrogram (VCUG) is a diagnostic imaging procedure that assesses the anatomy and function of the lower urinary tract. It focuses on the bladder, bladder neck, and urethra, helping detect abnormalities such as vesicoureteral reflux (VUR)—the backward or reverse flow of urine into the...
Imaging Studies V: Intravenous Urography and Retrograde Pyelography01:22

Imaging Studies V: Intravenous Urography and Retrograde Pyelography

IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...
Urinary Tract Calculi V: Nursing Management01:28

Urinary Tract Calculi V: Nursing Management

AssessmentSubjective Data: Obtain a detailed health history, including any recent or chronic urinary tract infections, periods of immobilization, previous episodes of renal calculi, and medical conditions such as gout, benign prostatic hyperplasia, or hyperparathyroidism. Review the medication history for drugs that may influence stone formation, including allopurinol, analgesics, loop diuretics, or thiazide diuretics. Document the use of long-term indwelling catheters and any past surgical...