Vesico-ureteral reflux. II. The longterm outcome of kidney function in non-surgical treatment

Seventy one patients were included in a prospective study of non-surgical treatment of vesico-ureteral reflux (VUR). We found 111 refluxing ureters, with 20 grade 1, 4 grade 2, 41 grade 3, 5 grade 4 and 1 grade 5. There was no correlation between presenting symptoms and degree of VUR or nephropathy, or between renal function in terms of glomerular filtration rate. During followup the patients were treated with long-term low-dose antibiotic prophylaxis and voiding disorders were corrected pharmacologically or by micturitional training. With a median follow up time of 6 years (3-10) 63% of the patients had cessation or down grading of VUR, irrespective of initial VUR degree. There was no correlation between cessation rate and urodynamic parameters, GFR, history of enuresis or previous urinary infections. The study supports a non-surgical attitude towards VUR patients irrespective of VUR degree, with prophylaxis of urinary infections and possibly correction of voiding disorders.