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Armamentarium to treat primary vesicoureteral reflux in children

Angela M Arlen1, Andrew J Kirsch2

  • 1Department of Urology, Yale University School of Medicine, New Haven, CT.

Seminars in Pediatric Surgery
|August 20, 2021
PubMed

Insights

Primary vesicoureteral reflux in children often resolves naturally. However, some cases risk kidney damage from infections, necessitating careful management strategies including antibiotics or surgery.

Area of Science:

  • Pediatric Nephrology
  • Urology

Background:

  • Primary vesicoureteral reflux (VUR) is common in children.
  • While many cases resolve spontaneously, untreated VUR can lead to recurrent pyelonephritis.
  • Recurrent pyelonephritis may cause irreversible renal damage.

Purpose of the Study:

  • To outline the management principles for pediatric primary vesicoureteral reflux.
  • To discuss the risks associated with untreated VUR, including renal scarring.
  • To review the diverse therapeutic options available for VUR.

Main Methods:

  • Review of current literature on pediatric vesicoureteral reflux.
  • Analysis of risk factors for recurrent urinary tract infections and renal damage.
  • Comparison of management strategies: observation, antibiotic prophylaxis, and surgical interventions.

Main Results:

  • Vesicoureteral reflux management is individualized based on UTI likelihood and renal injury risk.
  • Therapeutic options range from watchful waiting to surgical correction.
  • Continuous antibiotic prophylaxis is one management option.

Conclusions:

  • Management of pediatric VUR requires careful risk assessment.
  • Treatment aims to prevent recurrent infections and preserve renal function.
  • A spectrum of interventions exists, tailored to patient-specific factors.

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