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Vesico-ureteral reflux in children

B E Jakobsen, H Genster, S Olesen

    British Journal of Urology
    |April 1, 1977
    PubMed

    Insights

    Vesico-ureteral reflux (VUR) treatment in children shows reimplantation success rates of 86%. Grading VUR is crucial for effective treatment, with better outcomes in milder cases.

    Area of Science:

    • Pediatric Urology
    • Nephrology
    • Surgical Innovation

    Background:

    • Vesico-ureteral reflux (VUR) is a significant concern in pediatric urinary tract infections.
    • Renal scarring is a potential complication of untreated or inadequately treated VUR.
    • Effective management strategies are essential to prevent long-term renal damage.

    Purpose of the Study:

    • To evaluate the efficacy of different treatment modalities for VUR in children.
    • To assess the impact of VUR grading on treatment outcomes and renal scarring.
    • To determine the long-term success rates of conservative management, urethral surgery, and ureteral reimplantation.

    Main Methods:

    • Retrospective analysis of 126 children with 193 refluxing renal units treated between 1966-1974.
    • Classification of VUR into mild, moderate, and severe grades.
    • Comparison of outcomes for conservative treatment, urethral surgery, and Politano-Leadbetter ureteral reimplantation.

    Main Results:

    • Renal scarring rates were 5% (mild), 22% (moderate), and 28% (severe) VUR.
    • Success rates for reflux elimination: 50% (conservative), 60% (urethral surgery), and 86% (reimplantation).
    • 85% of upper urinary tracts normalized; 80% of children were symptom-free post-surgery, but 36% had persistent UTIs.

    Conclusions:

    • Ureteral reimplantation demonstrates the highest success rate for VUR elimination.
    • VUR grading is a valuable prognostic indicator, guiding treatment decisions.
    • While surgery improves symptoms and renal status, urinary tract infection persistence remains a challenge.

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