[Conservative drug therapy and surgical treatment of vesico-ureteral reflux. Current status, considerations and recommendations].
Long-term results recorded in the Birmingham and International Reflux Study are reported, and the implications for pediatricians and urologists are discussed. The risk of scarring is similar after conservative and after operative treatment, and reflux persists after 5 years of chemotherapy in 65-76% of children with grade III and IV reflux. Spontaneous maturation after 1-2 years is rare, and there is no point in conservative treatment with serious problems during pregnancy. A list of indications with due consideration for the chances of maturation, duration of chemotherapy and the risks involved in operation is proposed. The risks are remarkably low in endoscopic antireflux procedures, especially with collegen, and therefore a wide spectrum of relative indications is recommended, especially for groups with persisting severe reflux after 1 year of chemotherapy or such problems as breakthrough urinary infection and poor compliance.
Schrott
K M
KM
Urologische Universitätsklinik Erlangen.
D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000209:etiology; D011704:Pyelonephritis / Q000145:classification / Q000188:drug therapy / Q000601:surgery*; D012008:Recurrence; D014718:Vesico-Ureteral Reflux / Q000145:classification / Q000188:drug therapy / Q000601:surgery*