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Primary vesico-ureteric reflux: The need for individualised risk stratification
Guy Hidas1, Alexander Nam1, Tandis Soltani1
1Urology Department, University of California, Irvine, Orange, CA, USA.
Arab Journal of Urology
|November 19, 2015
Summary
Management of paediatric primary vesico-ureteric reflux (VUR) varies due to its heterogeneity. Individualized treatment based on risk factors like age, gender, and VUR grade is crucial for optimal outcomes.
Area of Science:
- Pediatric Nephrology
- Urology
Background:
- Paediatric primary vesico-ureteric reflux (VUR) management is evolving.
- Treatment strategies differ due to disorder heterogeneity and limited high-quality data.
Purpose of the Study:
- To review controversial issues in paediatric VUR management.
- To emphasize individualized patient care based on risk stratification.
Main Methods:
- Review of current literature on paediatric VUR.
- Analysis of demographic and clinical risk factors influencing VUR severity.
Main Results:
- Current management options include observation, antibiotic prophylaxis, and surgery.
- Surgical intervention is considered for breakthrough urinary tract infections (UTIs) or renal scarring.
- Risk factors include age, gender, ethnicity, VUR grade, laterality, scarring, presentation, UTI history, and voiding/bowel dysfunction.
Conclusions:
- Individualized management of paediatric VUR is essential.
- Risk stratification guides treatment decisions for better patient outcomes.
Keywords:
BBD, bladder and bowel dysfunctionBladder and bowel dysfunctionsCAP, continuous antibiotic prophylaxisContinuous antibiotic prophylaxisDimercaptosuccinic acid (DMSA)RCT, randomised control trialRenal scarsUS, ultrasonographyUrinary tract infectionVCUG, voiding cysto-urethrographyVesico-ureteric refluxVoiding cysto-urethrography
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