TY - JOUR
T1 - Vesicoureteral reflux
T2 - Who benefits from correction
AU - Austin, J. Christopher
AU - Cooper, Christopher S.
N1 - Copyright:
Copyright 2010 Elsevier B.V., All rights reserved.
PY - 2010/5
Y1 - 2010/5
N2 - There has been an emergence of a therapeutic nihilistic attitude about the surgical treatment of vesicoureteral reflux (VUR). Evidence-based reviews have questioned whether surgical treatment is beneficial for children with VUR. Even the use of prophylactic antibiotics, which have traditionally been the first-line therapy recommended for virtually all patients with VUR, has come under scrutiny after several randomized controlled trials found them to have no effect on decreasing the risk of urinary tract infections (UTIs) in children with VUR. Grade is the strongest predictor of VUR resolution, with high-grade VUR being much less likely to resolve. Other factors that negatively influence resolution include lower bladder volume or pressure at onset of reflux, older age, female sex, bilateral VUR, ureteral duplication, abnormal or scarred kidneys, and bladder dysfunction. These factors can be used, along with grade, in computer models or nomograms to improve the ability to predict spontaneous resolution.
AB - There has been an emergence of a therapeutic nihilistic attitude about the surgical treatment of vesicoureteral reflux (VUR). Evidence-based reviews have questioned whether surgical treatment is beneficial for children with VUR. Even the use of prophylactic antibiotics, which have traditionally been the first-line therapy recommended for virtually all patients with VUR, has come under scrutiny after several randomized controlled trials found them to have no effect on decreasing the risk of urinary tract infections (UTIs) in children with VUR. Grade is the strongest predictor of VUR resolution, with high-grade VUR being much less likely to resolve. Other factors that negatively influence resolution include lower bladder volume or pressure at onset of reflux, older age, female sex, bilateral VUR, ureteral duplication, abnormal or scarred kidneys, and bladder dysfunction. These factors can be used, along with grade, in computer models or nomograms to improve the ability to predict spontaneous resolution.
KW - Dimercaptosuccinic acid
KW - Pyelonephritis
KW - Urinary tract infections
KW - Vesicoureteral reflux
UR - http://www.scopus.com/inward/record.url?scp=77953524483&partnerID=8YFLogxK
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U2 - 10.1016/j.ucl.2010.03.012
DO - 10.1016/j.ucl.2010.03.012
M3 - Review article
C2 - 20569802
AN - SCOPUS:77953524483
SN - 0094-0143
VL - 37
SP - 243
EP - 252
JO - Urologic Clinics of North America
JF - Urologic Clinics of North America
IS - 2
ER -