Outcome at 10 years of severe vesicoureteric reflux managed medically: Report of the International Reflux Study in Children.
OBJECTIVE
To study the progress of vesicoureteric reflux (VUR) grade III or IV in children followed up prospectively over 10 years.


METHODS
One hundred forty-nine children (33 boys and 116 girls) with VUR were recruited for the International Reflux Study in Children and were treated with a medical regimen and monitored by means of serial cystograms. VUR disappearance was based on negative findings on 2 consecutive cystograms.


RESULTS
At 5 years, VUR with dilatation was seen in 72 (48%) children and VUR without dilatation, in 55 (37%); 22 (15%) children had no reflux. At 10 years, VUR with dilatation was seen in 34 (23%) children and VUR without dilatation, in 37 (25%); 78 (52%) children had no reflux. Grade IV VUR persisted in 8 children. Absence of VUR was significantly associated with grade III versus grade IV VUR (P = .007), unilateral versus bilateral reflux (P = .0002), and age > or = 5 years at entry versus age < 5 years (P = .001). Neither sex nor renal scarring at entry individually affected resolution of VUR. Among 43 (29%) children with intermittent VUR, only 6 had reflux with dilatation at 10 years.


CONCLUSIONS
Continuing reduction in the severity of VUR in children receiving careful medical treatment was observed over 10 years. On the basis of negative findings on 2 consecutive cystograms, VUR was absent in half of the children.
Smellie
J M
JM
Department of Pediatrics, University College London Hospitals, London, United Kingdom.
Jodal
U
U
Lax
H
H
Möbius
T T
TT
Hirche
H
H
Olbing
H
H
D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D015993:Life Tables; D008297:Male; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D014718:Vesico-Ureteral Reflux / Q000601:surgery / Q000628:therapy*