Skip to main content
British Medical Journal (Clinical Research Ed.) logoLink to British Medical Journal (Clinical Research Ed.)
. 1983 Jul 16;287(6386):171–174. doi: 10.1136/bmj.287.6386.171

Prospective trial of operative versus non-operative treatment of severe vesicoureteric reflux: two years' observation in 96 children.

PMCID: PMC1548688  PMID: 6409239

Abstract

Children with severe vesicoureteric reflux were allocated at random within three age groups (less than 1, 1-5, and greater than or equal to 6 years) to either operative or non-operative treatment. In 96 children who completed two years' observation there was no significant difference between treatment groups in either the incidence of breakthrough urinary tract infection, slope clearance of 51Cr-edetic acid, renal length, new scar formation, or progression of existing scars. Ureteric reimplantation was technically successful in 97% of cases, whereas 74% of ureters managed non-operatively still showed significant reflux at two years. No short term advantage was shown for either form of treatment in this series, but the long term effects of persistent, severe vesicoureteric reflux require further study. The prevention of reflux nephropathy probably demands the identification of vesicoureteric reflux before the advent of urinary tract infection, a goal not attainable with present invasive techniques.

Full text

PDF
171

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bailey R. R. The relationship of vesico-ureteric reflux to urinary tract infection and chronic pyelonephritis-reflux nephropathy. Clin Nephrol. 1973 May-Jun;1(3):132–141. [PubMed] [Google Scholar]
  2. Chantler C., Barratt T. M. Estimation of glomerular filtration rate from plasma clearance of 51-chromium edetic acid. Arch Dis Child. 1972 Aug;47(254):613–617. doi: 10.1136/adc.47.254.613. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Donckerwolcke R. A., Chantler C., Brunner F. P., Brynger H., Gurland H. J., Hathway R. A., Jacobs C., Selwood N. H., Wing A. J. Combined report on regular dialysis and transplantation of children in Europe, 1977. Proc Eur Dial Transplant Assoc. 1978;15:77–114. [PubMed] [Google Scholar]
  4. Edwards D., Normand I. C., Prescod N., Smellie J. M. Disappearance of vesicoureteric reflux during long-term prophylaxis of urinary tract infection in children. Br Med J. 1977 Jul 30;2(6082):285–288. doi: 10.1136/bmj.2.6082.285. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Eklöf O., Ringertz H. Kidney size in children. A method of assessment. Acta Radiol Diagn (Stockh) 1976 Sep;17(5A):617–625. doi: 10.1177/028418517601705a10. [DOI] [PubMed] [Google Scholar]
  6. MacGregor M. E., Freeman P. Childhood urinary infection associated with vesico-ureteric reflux. Q J Med. 1975 Jul;44(175):481–489. [PubMed] [Google Scholar]
  7. McLachlan M. S., Meller S. T., Jones E. R., Asscher A. W., Fletcher E. W., Mayon-White R. T., Ledingham J. G., Smith J. C., Johnston H. H. Urinary tract in schoolgirls with covert bacteriuria. Arch Dis Child. 1975 Apr;50(4):253–258. doi: 10.1136/adc.50.4.253. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. McRae C. U., Shannon F. T., Utley W. L. Effect on renal growth of reimplantation of refluxing ureters. Lancet. 1974 Jun 29;1(7870):1310–1312. doi: 10.1016/s0140-6736(74)90681-3. [DOI] [PubMed] [Google Scholar]
  9. Orikasa S., Takamura T., Inada F., Tsuji I. Effect of vesicoureteral reflux on renal growth. J Urol. 1978 Jan;119(1):25–30. doi: 10.1016/s0022-5347(17)57370-x. [DOI] [PubMed] [Google Scholar]
  10. Ransley P. G., Risdon R. A. Reflux nephropathy: effects of antimicrobial therapy on the evolution of the early pyelonephritic scar. Kidney Int. 1981 Dec;20(6):733–742. doi: 10.1038/ki.1981.204. [DOI] [PubMed] [Google Scholar]
  11. Rolleston G. L., Maling T. M., Hodson C. J. Intrarenal reflux and the scarred kidney. Arch Dis Child. 1974 Jul;49(7):531–539. doi: 10.1136/adc.49.7.531. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Shah K. J., Robins D. G., White R. H. Renal scarring and vesicoureteric reflux. Arch Dis Child. 1978 Mar;53(3):210–217. doi: 10.1136/adc.53.3.210. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Verrier Jones K., Asscher A. W., Verrier Jones E. R., Mattholie K., Leach K., Thomson G. M. Glomerular filtration rate in schoolgirls with covert bacteriuria. Br Med J (Clin Res Ed) 1982 Nov 6;285(6351):1307–1310. doi: 10.1136/bmj.285.6351.1307. [DOI] [PubMed] [Google Scholar]
  14. Wallace D. M., Rothwell D. L., Williams D. I. The long-term follow-up of surgically treated vesicoureteric reflux. Br J Urol. 1978 Dec;50(7):479–484. doi: 10.1111/j.1464-410x.1978.tb06195.x. [DOI] [PubMed] [Google Scholar]
  15. de Vargas A., Evans K., Ransley P., Rosenberg A. R., Rothwell D., Sherwood T., Williams D. I., Barratt T. M., Carter C. O. A family study of vesicoureteric reflux. J Med Genet. 1978 Apr;15(2):85–96. doi: 10.1136/jmg.15.2.85. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from British Medical Journal (Clinical research ed.) are provided here courtesy of BMJ Publishing Group

RESOURCES