Treatment of vesicoureteric reflux: results after 3 years in a prospective study.

Abstract

Between 1982 and 1986, 96 children with nonobstructive vesicoureteric reflux were treated in a prospective study. There were 134 refluxing ureters. Results are reported after a follow-up period of 3 years in 94 children with 130 refluxing ureters. Initially all children with reflux grade III or less had antibiotic treatment only. Those with reflux grade IV were randomized for antibiotic treatment alone versus surgery plus antibiotic treatment, while the primary treatment of reflux grade V was reimplantation. In 84 ureters treated by antibiotics alone, reflux disappeared in 52 cases and in 18 ureters the reflux was reduced. In 49 ureters treated by reimplantation, reflux was cured in 39 cases and no severe ureteric obstruction was seen. Conservative management of reflux grade IV was less successful than surgery. The results of conservative, nonsurgical treatment of reflux grade I to III are satisfactory, but for grades IV and V reflux surgery should be the treatment of choice, provided that detrusor instability can be excluded.