Vesicoureteral reflux

Abstract

Vesicoureteral reflux (VUR) is the most common disease of the urinary tract in children, occurring in 1-2% of the pediatric population and in 30-40% of children presenting with a urinary tract infection (UTI). The familial nature of VUR is well recognized. Siblings of children with VUR are at a much higher risk for reflux than the general pediatric population, with a reported prevalence between 25% and 50%. The association of VUR, febrile UTI, and renal parenchymal damage is well recognized. Reflux nephropathy is a cause of childhood hypertension and chronic renal failure. The main goals of treatment of children with VUR are to prevent renal parenchymal damage and prevent UTI. Treatment options for children with VUR include nonsurgical and surgical management. The various treatment options currently available for VUR are: (1) long-term antibiotic prophylaxis; (2) observation or intermittent treatment of UTIs as they occur, with management of bladder/bowel dysfunction (BBD) (3) minimally invasive endoscopic treatment; and (4) ureteral reimplantation by open, laparoscopic or robotic-assisted procedures.