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Vesicoureteral reflux in infants: what do we know about the gender prevalence by age?
N Capozza1, C Gulia, Z Heidari Bateni
1Urologic Surgery Unit, Pediatric Hospital "Bambino Gesù", Rome, Italy. aporrelloresearch@yahoo.com.
Insights
Vesicoureteral reflux (VUR) predominantly affects infant boys, but this gender disparity diminishes by age two. Understanding these differences is key for tailored VUR management in children.
Area of Science:
- Pediatric Urology
- Nephrology
- Genitourinary Medicine
Background:
- Vesicoureteral reflux (VUR) is a condition affecting up to 1% of Caucasian children, involving retrograde urine flow from the bladder to the kidneys.
- Existing literature presents conflicting data on VUR prevalence concerning gender and age in pediatric populations.
- Primary VUR results from an improperly functioning ureterovesicular junction.
Purpose of the Study:
- To analyze contradictions in reported VUR prevalence by gender and age in children.
- To offer a potential explanation for these discrepancies based on single-center data.
- To investigate VUR prevalence differences in children aged 0-2 years.
Main Methods:
- Retrospective analysis of VUR cases within a single pediatric center.
- Focus on the 0-2 year age interval to examine gender and age-related prevalence trends.
- Comparison of male/female VUR ratios over time within the studied age group.
Main Results:
- VUR is most prevalent in boys within the 0-2 year age range.
- The male-to-female ratio for VUR cases decreases progressively with age.
- Gender-based prevalence differences in VUR largely resolve by two years of age.
Conclusions:
- The natural history of VUR in male and female infants differs significantly.
- A gender-specific approach is necessary for managing VUR in young children.
- Current VUR categorization and clinical guidelines may require revision.
Objective:
Vesicoureteral reflux (VUR) affects up to 1% of Caucasian children. Primary VUR is characterized by failure of the ureterovesicular junction to prevent urine from traveling in a retrograde fashion from the bladder to the ureters and the kidneys. Several reports in the literature describe the prevalence of this condition in pediatric patients; overall, VUR affects more males during infancy and with higher grades. However, a thorough consideration of these articles reveals important contradictions regarding the prevalence by gender and age. We analyzed those contradictions and suggested a possible explanation based on our single center experience with this patient group. In particular, for the age interval 0-2 years: we have found that (1) VUR mostly affects boys; (2) the male/female ratio steadily declines over time; (3) the unequal prevalence between males and females essentially disappears when children reach the age of two years.
Conclusions:
The natural history of VUR in infant boys differs from that of infant girls, and therefore requires a gender-specific approach. Available data support the need to redefine the categorization and clinical guidelines for this disease.
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