title: [Primary vesicoureteral reflux: conservative therapy or surgical intervention].
abstract: BACKGROUND
  The relationship between urinary tract infections and primary vesicoureteral reflux may lead to permanent renal damage. In the literature an increasing number of spontaneous cure of vesicoureteral reflux in children and the significant decrease in surgical therapy has been observed.
  
  
  OBJECTIVE
  To study the evolution of primary vesicoureteral reflux associated with recurring urinary tract infections settings in patients of the Pediatric Nephrology department of our institution, evaluating cases in which cure was achieved through conservative therapy only and those in which surgical intervention was required.
  
  
  METHODS
  We analyzed records and collected data refers to parameters: sex, age upon the diagnosis of primary urinary infection, age upon diagnosis of vesicoureteral reflux, number of urinary tract infections, vesicoureteral reflux grade; renal function, renal scaring, other malformation of urinary tract, and surgical or conservative intervention. Statistical analysis was descriptive and conducted with the SPSS program.
  
  
  RESULTS
  Within the subgroup of patients with grade IV and V, 63.6% of the cases evolved to surgical intervention and 36.4% to conservative intervention. In those with grades I, II, and III, 38.5% evolved to surgical treatment against 61.5% for conservative approach. Among those with bilateral vesicoureteral reflux, 72.7% had to undergo surgical intervention. No relationship was observed between the vesicoureteral reflux grade and the presence of renal scaring.
  
  
  CONCLUSIONS
  Patients with low grade vesicoureteral reflux and recurring urinary tract infections tend to experience spontaneous reflux resolution with good renal evolution in the long term in a way that surgical intervention becomes limited to high grade reflux or when followed by other clinical issues.
authors.affiliation: Escola Paulista de Medicina, Universidade Federal de Sao Paulo.
authors.forename: Camila Borges Bezerra
authors.initials: CB
authors.lastname: Teixeira
authors.affiliation: Escola Paulista de Medicina, Universidade Federal de Sao Paulo.
authors.forename: Maria Aparecida de Paula
authors.initials: MA
authors.lastname: Cançado
authors.affiliation: Escola Paulista de Medicina, Universidade Federal de Sao Paulo.
authors.forename: João Tomás de Abreu
authors.initials: JT
authors.lastname: Carvalhaes
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012008:Recurrence; D012189:Retrospective Studies; D014552:Urinary Tract Infections / Q000209:etiology* / Q000628:therapy*; D014718:Vesico-Ureteral Reflux / Q000150:complications* / Q000601:surgery / Q000628:therapy*