Vesicoureteral reflux: who benefits from surgery?
Increased recognition of the association between urinary tract infections and reflux, sibling screening, and the evaluation of antenatal hydronephrosis have resulted in an increase in the diagnosis of reflux early in life. Although many children would sustain no untoward affects of their condition if reflux were left untreated, the disease can be severe and even life threatening. Although antireflux operations have been refined and improved, it remains difficult to determine which individuals truly benefit from these operations. A large prospective randomized placebo-antibiotic-operation study with long-term follow-up is needed, as is the development of nomograms, to assess the individual child's risk of adverse outcomes.
Cooper
Christopher S
CS
Division of Pediatric Urology, University of Iowa and the Children's Hospital of Iowa, 200 Hawkins Drive, 3 RCP, Iowa City, IA 52242-1089, USA. christopher-cooper@uiowa.edu
Austin
J Christopher
JC
D002648:Child; D006801:Humans; D016896:Treatment Outcome; D014563:Urodynamics; D014718:Vesico-Ureteral Reflux / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*