Physical growth velocity during conservative treatment and following subsequent surgical treatment for primary vesicoureteric reflux.
Physical growth was studied in 6 males and 16 females during 1 year of antimicrobial prophylaxis and during the 2 years following subsequent surgical treatment for severe primary vesicoureteric reflux. Surgery was performed between the ages of 2 and 8 because of either repeated breakthrough infection or persistence of grade III or IV reflux. Height and weight velocities were calculated as yearly rates and then converted into interquartile ratios (IQRs). Neither the mean centile height nor weight attained varied significantly between that at entry, after 1 year of medical treatment and at 2 years after surgery. However, the mean IQR for height velocity (+/- sem) rose significantly from -0.61 (+/- 0.45) during antimicrobial prophylaxis to 0.54 (+/- 0.25) following surgery. Similarly, the mean IQR for weight velocity rose significantly from -0.63 (+/- 0.50) during medical treatment to 0.47 (+/- 0.24) following surgery. These results suggest that surgical treatment is preferable to continued medical treatment in patients with severe primary vesicoureteric reflux who fail to respond to a trial of antimicrobial prophylaxis.
Sutton
R
R
Wessex Regional Centre for Paediatric Surgery, Southampton General Hospital.
Atwell
J D
JD
D000892:Anti-Infective Agents, Urinary / Q000627:therapeutic use; D001827:Body Height; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D014552:Urinary Tract Infections / Q000517:prevention & control; D014718:Vesico-Ureteral Reflux / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D015430:Weight Gain
D000892:Anti-Infective Agents, Urinary