[Conservative and surgical therapy of vesicoureterorenal reflux]

The pathogenesis of reflux nephropathy and morbidity is discussed first, then chances of spontaneous maturation and risks for scarring are compared with resulting guidelines for conservative and operative treatment. A list of indications is proposed regarding grade of reflux, age, essential diagnostic parameters (VC, cystoscopy, IVP), history and other clinical aspects. Over and above this, an "ephedrine-test" developed at Erlangen in 1976 is described with regard to possible adrenergic treatment of primary reflux. Results of over 500 Gregoir-Lich procedures from 1963 to 1976 are presented with rates of stenosis (0-2%) and failure (4.3-5.2%), complications and persistence of infection. Finally, a short review is presented of the morphology and management of secondary reflux (associated with infravesical obstruction).