Resolution of vesicoureteral reflux in completely duplicated systems: fact or fiction?
A total of 60 patients (71 renal units) with grade 2/5 vesicoureteral reflux into the lower pole moiety of a completely duplicated system was managed by medical surveillance and is compared to an identically managed age, race and sex matched control population with a similar degree of reflux into a single collecting system. During a median 2-year observation period reflux ceased spontaneously in 10% of the patients with duplication compared to 35% of the control population (p less than 0.01). Comparisons between the 2 study groups failed to reveal a difference in the incidence of break-through urinary tract infections, advancing degrees of reflux and/or the development or progression of renal scarring (p greater than 0.5). Despite the fact that the resolution rate in duplex systems is significantly lower than that of a single system, it is apparent that cessation of grade 2/5 reflux into a duplicated ureter will occur and that a trial of medical management is an appropriate initial method of therapy.
Husmann
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DA
Department of Surgery, University of Texas Southwestern Medical Center, Dallas.
Allen
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TD
D000206:Actuarial Analysis; D002648:Child; D006801:Humans; D015994:Incidence; D013997:Time Factors; D014513:Ureter / Q000002:abnormalities*; D014552:Urinary Tract Infections / Q000453:epidemiology; D014718:Vesico-Ureteral Reflux / Q000453:epidemiology / Q000503:physiopathology*