Vesicoureteric reflux in children

• Published in: The Lancet (British edition) Vol. 385; no. 9965; pp. 371 - 379
• Main Author: Tullus, Kjell, Dr
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 24-01-2015; Elsevier Limited
• Subjects: Adult; Anti-Bacterial Agents - therapeutic use; Antibiotic Prophylaxis; Antibiotics; Bladder; Child; Child, Preschool; Children & youth; Cicatrix - etiology; Early Diagnosis; Endoscopy; Female; Humans; Infant; Infant, Newborn; Infections; Injections, Intralesional; Internal Medicine; Kidney Diseases - etiology; Kidney Diseases - physiopathology; Pediatrics; Practice Guidelines as Topic; Pregnancy; Pregnancy Complications - etiology; Remission, Spontaneous; Replantation - methods; Studies; Surgery; Time-to-Treatment; Urinary Tract Infections - complications; Urine; Urodynamics; Urogenital system; Urological Agents - administration & dosage; Vesico-Ureteral Reflux - diagnosis; Vesico-Ureteral Reflux - etiology; Vesico-Ureteral Reflux - therapy; Australia
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/S0140-6736(14)60383-4

Summary Vesicoureteric reflux is defined as the retrograde passage of urine from the bladder into one or both ureters and often up to the kidneys, and mainly affects babies and infants. In severe cases dilatation of the ureter, renal pelvis, and calyces might be seen. Traditionally it was thought that only a low percentage of children have vesicoureteric reflux, but studies have suggested as many as 25–40% are affected. Guidelines recommend that the number of investigations for vesicoureteric reflux in children who have had a febrile urinary tract infection be reduced, but this approach is controversial. The recommendations also suggest that prophylactic antibiotics and surgery should be avoided in children with non-severe vesicoureteric reflux. In this Seminar I present data on the management of children with vesicoureteric reflux and give suggestions on how to navigate this difficult area.