Resolution Rates of Low Grade Vesicoureteral Reflux Stratified by Patient Age at Presentation

No AccessJournal of UrologyPediatric Urology: Review Article1 Apr 1997Resolution Rates of Low Grade Vesicoureteral Reflux Stratified by Patient Age at Presentation Saul P. Greenfield, Manyan Ng, and Julian Wan Saul P. GreenfieldSaul P. Greenfield More articles by this author , Manyan NgManyan Ng More articles by this author , and Julian WanJulian Wan More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)65004-3AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Most children with grades I to III primary vesicoureteral reflux are monitored for years on antibiotic prophylaxis until reflux resolves. While the overall resolution rate of these grades is known, the rates for various patient ages at presentation are unknown. Therefore, we examined resolution rates of these grades for different ages at presentation. Materials and Methods: From 1985 through 1990, 168 boys (245 ureters) and 433 girls (590 ureters) with all grades of reflux were enrolled in the study and monitored through the end of 1993. Urine cultures were obtained every 4 months and contrast voiding cystourethrography was repeated every 18 months. Age at presentation was stratified into groups younger than 1, 1 to 3, 4 to 6, 7 to 9, and 10 years and older. Resolution rates were then calculated for grades I to III reflux for each age at presentation. Time to resolution was also evaluated for each age and grade. Results: There were no significant differences between rates of resolution at different ages for each grade. Children less than 10 years old had as high a likelihood of resolution as infants. Neither sex nor bilaterality versus unilaterality was a helpful predictor of resolution. Time to resolution varied widely and it was also not helpful for identifying the cases of reflux that resolved. Conclusions: Low grade vesicoureteral reflux may not resolve until adolescence and age at presentation is not a reliable predictive factor. Children should remain on prophylaxis for many years unless definitive correction is undertaken. References 1 : Prospective trial of operative vs non-operative treatment of severe vesicoureteral reflux in children: five years' observation. Brit. Med. J.1987; 295: 237. Google Scholar 2 : A nonsurgical approach to the management of primary vesico-ureteral reflux. J. Urol., part 21987; 138: 941. Abstract, Google Scholar 3 : on behalf of the International Reflux Study in Children: Results of randomized clinical trial of medical versus surgical management of infants and children with grades III and IV primary vesicoureteral reflux (United States). J. Urol., part 21992; 148: 1667. 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Abstract, Google Scholar From the Department of Pediatric Urology, Children's Hospital of Buffalo, State University of New York at Buffalo School of Medicine, Buffalo, New York© 1997 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byCopp H, Nelson C, Shortliffe L, Lai J, Saigal C and Kennedy W (2018) Compliance With Antibiotic Prophylaxis in Children With Vesicoureteral Reflux: Results From a National Pharmacy Claims DatabaseJournal of Urology, VOL. 183, NO. 5, (1994-2000), Online publication date: 1-May-2010.Shiraishi K, Matsuyama H, Nepple K, Wald M, Niederberger C, Austin C and Cooper C (2018) Validation of a Prognostic Calculator for Prediction of Early Vesicoureteral Reflux Resolution in ChildrenJournal of Urology, VOL. 182, NO. 2, (687-691), Online publication date: 1-Aug-2009.McMillan Z, Austin J, Knudson M, Hawtrey C and Cooper C (2018) Bladder Volume at Onset of Reflux on Initial Cystogram Predicts Spontaneous ResolutionJournal of Urology, VOL. 176, NO. 4S, (1838-1841), Online publication date: 1-Oct-2006.SCHWAB C, WU H, SELMAN H, SMITH G, SNYDER H and CANNING D (2018) Spontaneous Resolution of Vesicoureteral Reflux: A 15-Year PerspectiveJournal of Urology, VOL. 168, NO. 6, (2594-2599), Online publication date: 1-Dec-2002.NEEL K and SHILLINGER J (2018) THE PREVALENCE OF PERSISTENT VESICOURETERAL REFLUX AFTER 1 NEGATIVE NUCLEAR MEDICINE CYSTOGRAMJournal of Urology, VOL. 164, NO. 3 Part 2, (1067-1069), Online publication date: 1-Sep-2000.KOFF S, WAGNER T and JAYANTHI V (2018) THE RELATIONSHIP AMONG DYSFUNCTIONAL ELIMINATION SYNDROMES, PRIMARY VESICOURETERAL REFLUX AND URINARY TRACT INFECTIONS IN CHILDRENJournal of Urology, VOL. 160, NO. 3 Part 2, (1019-1022), Online publication date: 1-Sep-1998. Volume 157Issue 4April 1997Page: 1410-1413 Advertisement Copyright & Permissions© 1997 by American Urological Association, Inc.MetricsAuthor Information Saul P. Greenfield More articles by this author Manyan Ng More articles by this author Julian Wan More articles by this author Expand All Advertisement PDF downloadLoading ...