Treatment of vesicoureteric reflux. Preliminary report of a prospective study

Abstract

Between 1982 and 1986 95 children with non-obstructive vesicoureteric reflux were treated in a prospective study. Preliminary results are reported on 94 children with 137 refluxing ureters and a follow-up period of at least 18 months. All children with reflux grade III or less had antibiotic treatment only. Those with reflux grade IV were randomised for antibiotic treatment alone versus surgery plus antibiotic treatment, while the primary treatment of reflux grade V was reimplantation. In 91 ureters treated by antibiotics alone, reflux disappeared in 49 cases; in 20 cases the grade of reflux was reduced. In 46 ureters treated by reimplantation, reflux was cured in 40 cases and no severe ureteric obstruction was seen. Conservative management of reflux grade IV seems to be less successful than surgery. The results of conservative, non-surgical treatment of reflux grade I to III are satisfactory, but for grades IV and V reflux surgery seems to be the treatment of choice if detrusor instability can be excluded.