[Vesicorenal reflux]

Abstract

For vesicorenal reflux an incidence of 16 to 17% is described. In 85% girls are affected except in the antenately detected reflux. Ascending infections are the pathomechanism. A reflux can be diagnosed in up to 70% of children with febrile urinary tract infection. The probability of spontaneous maturation is highest in low grade and unilateral reflux as well as during the first year of life. During time to maturation antibiotic prophylaxis can avoid urinary tract infections (conservative treatment). Break-through infections, high grade reflux, loss of kidney function, associated malformations and bad patients compliance represent indications for operative reflux repair. Surgery should more often be considered in girls (higher risk for urinary tract infections, pregnancy). Success rates of reflux surgery are high (>90%). Endoscopy is quoted to be an alternative, however, success rates are lower and long-term results of the new substances are still lacking.