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Cessation of Vesicoureteral Reflux For 5 Years in Infants and Children Allocated to Medical Treatment

1992; Lippincott Williams & Wilkins; Volume: 148; Issue: 5 Part 2 Linguagem: Inglês

10.1016/s0022-5347(17)36997-5

1527-3792

Tytti Tamminen-Möbius, E Brunier, Kl.-D. Ebel, Robert L. Lebowitz, H Olbing, Ulpu Seppänen, Rune Sixt,

Ureteral procedures and complications

No AccessJournal of Urology1 Nov 1992Cessation of Vesicoureteral Reflux For 5 Years in Infants and Children Allocated to Medical Treatment T. Tamminen-Möbius, E. Brunier, K.D. Ebel, R. Lebowitz, H. Olbing, U. Seppänen, R. Sixt, and On Behalf of the International Reflux Study in Children T. Tamminen-MöbiusT. Tamminen-Möbius , E. BrunierE. Brunier , K.D. EbelK.D. Ebel , R. LebowitzR. Lebowitz , H. OlbingH. Olbing , U. SeppänenU. Seppänen , R. SixtR. Sixt , and On Behalf of the International Reflux Study in Children View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)36997-5AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail A total of 401 children with severe vesicoureteral reflux (97 with grade III and 304 with grade IV) was entered into the European branch of the International Reflux Study in Children. Of these patients 37 with grade III and 43 with grade IV reflux were allocated to medical treatment as a sideline group because the reflux grade III or IV had improved to grade II or I, or it had disappeared during the preceeding 2 to 6 months (median 4). Of the remaining 321 patients with persistent grade III or IV reflux 158 were randomly allocated to medical treatment of whom 3 switched to surgery. We report on 235 children treated medically (155 random medical and 80 sideline), of whom 88% had a complete 5-year followup with x-ray and/or isotope voiding cystourethrography at 6, 18, 30 and 54 months. Seven children dropped out of the study after a followup of 6 months or less, including 6 with persistent vesicoureteral reflux. Cessation of vesicoureteral reflux was observed significantly more often in children with unilateral (40 of 74, 54%) than with bilateral (18 of 154, 12%) reflux (p <0.001). No significant difference between grades III and IV was noted. Vesicoureteral reflux ceased in 25 of 153 children (16%) from the random medical group and in 32 of 75 children (43%) in the sideline group. Of 194 children with vesicoureteral reflux detected for the first time at entry reflux resolved in 55 (28%). In only 2 of 34 children (6%) in whom vesicoureteral reflux was detected more than 1 year before entry did reflux resolve after 5 years. Among the children in whom vesicoureteral reflux either disappeared, diminished or remained unchanged the proportion with urinary tract infection recurrences was almost the same. © 1992 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited ByWang H, Gbadegesin R, Foreman J, Nagaraj S, Wigfall D, Wiener J and Routh J (2018) Efficacy of Antibiotic Prophylaxis in Children with Vesicoureteral Reflux: Systematic Review and Meta-AnalysisJournal of Urology, VOL. 193, NO. 3, (963-969), Online publication date: 1-Mar-2015.Greenfield S, Carpenter M, Chesney R, Zerin J and Chow J (2012) The RIVUR Voiding Cystourethrogram Pilot Study: Experience with Radiologic Reading ConcordanceJournal of Urology, VOL. 188, NO. 4S, (1608-1612), Online publication date: 1-Oct-2012.Storm D, Koff S, Horvath D, Li B and Justice S (2011) In Vitro Analysis of the Bactericidal Activity of Escherichia Coli Nissle 1917 Against Pediatric UropathogensJournal of Urology, 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Vesicoureteral RefluxJournal of Urology, VOL. 148, NO. 5 Part 2, (1676-1678), Online publication date: 1-Nov-1992. Volume 148Issue 5 Part 2November 1992Page: 1662-1666 Advertisement Copyright & Permissions© 1992 by The American Urological Association Education and Research, Inc.MetricsAuthor Information T. Tamminen-Möbius More articles by this author E. Brunier More articles by this author K.D. Ebel More articles by this author R. Lebowitz More articles by this author H. Olbing More articles by this author U. Seppänen More articles by this author R. Sixt More articles by this author On Behalf of the International Reflux Study in Children More articles by this author Expand All Advertisement Loading ...