title: [Conservative versus interventional treatment of primary vesicoureteral reflux in children].
abstract: OBJECTIVE
  To assess the efficacy of medical and surgical treatment of vesicoureteral reflux (VUR) in children using recurrence of urinary tract infections, renal scarring and renal function as end-points.
  
  
  RESULTS
  We performed a MEDLINE search for articles. We selected only randomized clinical trials and meta-analysis that analyzed medical versus surgical treatment of VUR in children. A total of 820 patients were included in all studies. We found no statistatically significant differences between surgically and medically treated patients in terms of scarring, kidney function or recurrence of urinary tract infections. There was only a significant decrease in the frequency of febrile UTI in patients who were surgically corrected, compared with those receiving antibiotics alone (RR 0.43).
  
  
  CONCLUSIONS
  We found no clinically significant differences between surgical and medical treatment for VUR in terms of kidney function or renal scarring. We suggest that a child with UTI and VUR should be treated conservatively at first.
authors.affiliation: Unidad de Nefrología Pediátrica, Hospital Universitario Sant Joan, Universidad Rovira i Virgili, Reus, Tarragona, España. jescribano@grupsagessa.com
authors.forename: Joaquín
authors.initials: J
authors.lastname: Escribano Subias
authors.forename: Gloria
authors.initials: G
authors.lastname: Fraga Rodríguez
mesh_terms: D002648:Child; D002675:Child, Preschool; D004108:Dilatation, Pathologic / Q000209:etiology; D006801:Humans; D007223:Infant; D014718:Vesico-Ureteral Reflux / Q000150:complications / Q000601:surgery / Q000628:therapy*