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Treatment of vesicoureteric reflux. Results of a prospective study

R J Scholtmeijer1

  • 1Department of Paediatric Urology, Sophia Children's Hospital, Erasmus University, Rotterdam, The Netherlands.

British Journal of Urology
|March 1, 1993
PubMed

Insights

For children with vesicoureteric reflux (VUR), antibiotic treatment is effective for low grades (I-III). Surgery is recommended for higher grades (IV-V) to ensure successful outcomes.

Area of Science:

  • Pediatric Urology
  • Nephrology

Background:

  • Vesicoureteric reflux (VUR) is a common condition in children.
  • Management strategies for VUR vary based on reflux grade.

Purpose of the Study:

  • To evaluate the efficacy of different management strategies for non-obstructive VUR in children.
  • To compare conservative (antibiotic) versus surgical treatment for various VUR grades.

Main Methods:

  • Prospective study of 93 children (135 refluxing ureters) followed for at least 5 years.
  • Initial treatment based on VUR grade: antibiotics for grades I-III, randomization for grade IV (antibiotics vs. surgery), reimplantation for grade V.
  • Outcomes assessed included reflux resolution and ureteric obstruction.

Main Results:

  • Antibiotic treatment alone resolved reflux in 64/85 ureters (grades I-III) and reduced it in 12.
  • Surgery (reimplantation) cured reflux in 46/50 ureters (grade V) without severe obstruction.
  • Conservative management was less successful for grade IV VUR compared to surgery.

Conclusions:

  • Conservative, non-surgical management is satisfactory for low-grade VUR (I-III).
  • Surgery is the preferred treatment for high-grade VUR (IV-V), provided detrusor instability is excluded.

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