Abstract | PURPOSE: The spontaneous resolution rate of vesicoureteral reflux is helpful for determining the need for surgical intervention and the proper followup schedule in patients on antibiotic prophylaxis. We determined the resolution rate by patient rather than by ureter and analyzed the effects of laterality, gender, age and dysfunctional voiding. MATERIALS AND METHODS: We retrospectively reviewed the records of 179 girls and 35 boys who presented between 1981 and 1984 with urinary tract infection and were diagnosed with primary vesicoureteral reflux. Mean age at presentation was 4.2 years and median followup was 3 years. Of the patients 107 (50%) had bilateral reflux and 60 had dysfunctional voiding. In 146 children (68%) reflux spontaneously resolved during the study. Patients were categorized by the worst grade of reflux, maintained on antibiotic prophylaxis and underwent voiding cystourethrography yearly until reflux resolved. Kaplan-Meier curves were constructed to define the resolution rate. RESULTS: Grades I to III reflux resolved at 13% yearly during the initial 5 years of followup and then at 3.5% yearly during subsequent followup. Grade IV to V reflux resolved at 5% rate yearly. Bilateral reflux resolved more slowly than unilateral reflux and it resolved more rapidly in boys than in girls. Untreated dysfunctional voiding had no effect on overall resolution. CONCLUSIONS:
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Authors | C William Schwab Jr, Hsi-Yang Wu, Heather Selman, Grahame H H Smith, Howard M Snyder 3rd, Douglas A Canning |
Journal | The Journal of urology
(J Urol)
Vol. 168
Issue 6
Pg. 2594-9
(Dec 2002)
ISSN: 0022-5347 [Print] United States |
PMID | 12441993
(Publication Type: Journal Article)
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Topics |
- Adolescent
- Antibiotic Prophylaxis
- Child
- Child, Preschool
- Female
- Humans
- Infant
- Male
- Remission, Spontaneous
- Retrospective Studies
- Urinary Tract Infections
(etiology, prevention & control)
- Vesico-Ureteral Reflux
(complications, diagnosis, physiopathology)
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