[Conservative versus interventional treatment of primary vesicoureteral reflux in children].
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.
Escribano Subias
Joaquín
J
Unidad de Nefrología Pediátrica, Hospital Universitario Sant Joan, Universidad Rovira i Virgili, Reus, Tarragona, España. jescribano@grupsagessa.com
Fraga Rodríguez
Gloria
G
D002648:Child; D002675:Child, Preschool; D004108:Dilatation, Pathologic / Q000209:etiology; D006801:Humans; D007223:Infant; D014718:Vesico-Ureteral Reflux / Q000150:complications / Q000601:surgery / Q000628:therapy*