The Factors Affecting the Outcome after Medical Management of Vesicoureteral Reflux

Sung Yul Park; Hae Young Park; Young Nam Woo

doi:10.4111/kju.2006.47.9.994

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Park, Park, and Woo: The Factors Affecting the Outcome after Medical Management of Vesicoureteral Reflux

Original Article

Korean Journal of Urology

Korean Journal of Urology 2006; 47(9): 994-1000.

Published online: 30 September 2006

DOI: https://doi.org/10.4111/kju.2006.47.9.994

The Factors Affecting the Outcome after Medical Management of Vesicoureteral Reflux

Sung Yul Park, Hae Young Park, Young Nam Woo

Department of Urology, Hanyang University College of Medicine, Seoul, Korea.

Corresponding author (w1004@hanyang.ac.kr)

Received 13 December 2005 Accepted 19 July 2006

Abstract

Purpose

We analyzed the outcome of medical management for children with vesicoureteral reflux (VUR) and we determined the factors affecting the outcome.

Materials and Methods

We retrospectively reviewed the records of 37 patients (56 kidneys) who were diagnosed with VUR between 1995 and 2004. All the patients were maintained on prophylactic antibiotics and had regular follow up. The subjects were stratified according to the grade of reflux at the time of diagnosis into the low grade group (grade III or below) or the high grade group (grade IV or above), based upon the International Classification System. The effects of the reflux grade, the presence or absence of renal scar, the age at diagnosis, laterality of disease and gender on the improvement/resolution rate of VUR were analyzed.

Results

The mean duration until resolution was 35 months. Improvement occurred in 48 kidneys, including resolution in 27 kidneys. The resolution rate was higher in the kidneys with low grade reflux than that in the kidneys with high grade reflux. The resolution rate was higher in kidneys without scar than that in the kidneys with scar. A significantly higher improvement rate was observed for the children diagnosed before 1 year of age than that for the children diagnosed after 1 year of age.

Conclusions

The most significant factor determining the outcome of medical management for children with VUR is the reflux grade at diagnosis. Medical management is appropriate in the management of low grade VUR. It may also be a viable treatment option for high grade VUR in selected cases.

Keywords: Vesico-ureteral reflux, Treatment outcome, Medical practice management,

Figures and Tables

Table 1

Characteristics of the 37 patients with vesicoureteral reflux

^*: low grade (grade I-III), high grade (grade IV-V)

Table 2

Medical treatment outcome of vesicoureteral reflux (VUR) according to gender, age at diagnosis, the reflux grade, presence or absence of renal scar and laterality of disease

^*: low grade (grade I-III), high grade (grade IV-V)

Table 3

Medical treatment outcome of vesicoureteral reflux (VUR) according to presence or absence of renal scar in the kidneys with different reflux grades

^*: low grade (grade I-III), high grade (grade IV-V)

Table 4

Medical treatment outcome of vesicoureteral reflux (VUR) according to the age at diagnosis for different reflux grades

^*: low grade (grade I-III), high grade (grade IV-V)

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