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Prenatally diagnosed reflux: a follow-up study.
A C Gordon1, D F Thomas, R J Arthur
1Department of Paediatric Surgery, General Infirmary, Leeds.
British Journal of Urology
|April 1, 1990
Summary
Prenatally detected vesicoureteric reflux (VUR) in infants often presents in males with high-grade reflux and associated abnormalities. While many cases resolve spontaneously or respond to chemoprophylaxis, some require surgical intervention.
Area of Science:
- Pediatric Urology
- Neonatal Medicine
- Medical Imaging
Background:
- Vesicoureteric reflux (VUR) is a common congenital anomaly in infants.
- Prenatal detection of VUR is typically based on fetal urinary tract dilatation.
- Understanding the characteristics and outcomes of prenatally detected VUR is crucial for management.
Purpose of the Study:
- To analyze the characteristics and outcomes of infants with prenatally detected VUR.
- To compare the demographic and clinical features of prenatally diagnosed VUR with those presenting clinically.
- To evaluate the effectiveness of chemoprophylaxis and the rate of spontaneous resolution.
Main Methods:
- Retrospective analysis of 25 infants with prenatally diagnosed VUR.
- Assessment of reflux grade, bilaterality, and coexistent congenital abnormalities.
- Monitoring of urinary tract infections, treatment outcomes (chemoprophylaxis, surgery), and spontaneous resolution rates.
Main Results:
- 84% of infants were male, contrasting with female predominance in clinically presenting VUR.
- VUR was predominantly high-grade (usually IV) and often bilateral (16/25 infants).
- 32% of infants had coexistent congenital abnormalities; 68% remained infection-free with chemoprophylaxis, while 20% required surgery.
Conclusions:
- Prenatally detected VUR in infants exhibits distinct characteristics, including a male predominance and higher grades of reflux.
- Chemoprophylaxis is effective in a majority of cases, but a significant proportion may still require surgical intervention.
- Spontaneous resolution occurs in a notable percentage of cases, highlighting the importance of long-term follow-up.