title: Pediatric Vesicoureteral Reflux Guidelines Panel summary report on the management of primary vesicoureteral reflux in children.
abstract: OBJECTIVE
  The American Urological Association convened the Pediatric Vesicoureteral Reflux Guidelines Panel to analyze the literature regarding available methods for treating vesicoureteral reflux diagnosed following a urinary tract infection in children and to make practice policy recommendations based on the treatment outcomes data insofar as the data permit.
  
  
  METHODS
  The panel searched the MEDLINE data base for all articles from 1965 to 1994 on vesicoureteral reflux and systematically analyzed outcomes data for 7 treatment alternatives: 1) intermittent antibiotic therapy, 2) bladder training, 3) continuous antibiotic prophylaxis, 4) antibiotic prophylaxis and bladder training, 5) antibiotic prophylaxis, anticholinergics and bladder training, 6) open surgical repair and 7) endoscopic repair. Key outcomes identified were probability of reflux resolution, likelihood of developing pyelonephritis and scarring, and possibility of complications of medical and surgical treatment.
  
  
  RESULTS
  Available outcomes data on the various treatment alternatives were summarized in tabular form and graphically, and the relative probabilities of possible outcomes were compared for each alternative. Treatment recommendations were based on scientific evidence and expert opinion. The panel concluded that only a few recommendations can be derived purely from scientific evidence of a beneficial effect on health outcomes.
  
  
  CONCLUSIONS
  For most children the panel recommended continuous antibiotic prophylaxis as initial treatment. Surgery was recommended for children with persistent reflux and other indications, as specified in the document.
authors.forename: J S
authors.initials: JS
authors.lastname: Elder
authors.forename: C A
authors.initials: CA
authors.lastname: Peters
authors.forename: B S
authors.initials: BS
authors.lastname: Arant
authors.forename: D H
authors.initials: DH
authors.lastname: Ewalt
authors.forename: C E
authors.initials: CE
authors.lastname: Hawtrey
authors.forename: R S
authors.initials: RS
authors.lastname: Hurwitz
authors.forename: T S
authors.initials: TS
authors.lastname: Parrott
authors.forename: H M
authors.initials: HM
authors.lastname: Snyder
authors.forename: R A
authors.initials: RA
authors.lastname: Weiss
authors.forename: S H
authors.initials: SH
authors.lastname: Woolf
authors.forename: V
authors.initials: V
authors.lastname: Hasselblad
mesh_terms: D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D014718:Vesico-Ureteral Reflux / Q000628:therapy*