Disease management

The main management goal is the preservation of kidney function, by minimizing the risk of pyelonephritis.

There are two main treatment approaches:

The objective of conservative therapy is the prevention of febrile UTI.

Vesicoureteric reflux resolves spontaneously, mostly in young patients with low-grade reflux.

Resolution is nearly 80% in VUR grades I and II and 30-50% in VUR grades III-V within four to five years of follow-up.

The conservative approach includes watchful waiting, intermittent or continuous antibiotic prophylaxis, and bladder rehabilitation in those with LUTD.

Circumcision during early infancy may be considered as part of the conservative approach because it is effective in reducing the risk of infection in normal children.

Surgical treatment can be carried out by endoscopic injection of bulking agents or ureteral reimplantation.

  • Subureteric injection of bulking materials
    The success rate for the subureteric transurethral injection (STING) approach varies from 70% to 90%, depending on the grade of the reflux.
  • Ureteral reimplantation
    All techniques have been shown to be safe, with a low rate of complications and excellent success rates (92-98%).
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