UNILATERAL VESICOURETERAL REFLUX - ASSOCIATION WITH PROTECTED RENAL-FUNCTION IN PATIENTS WITH POSTERIOR URETHRAL VALVES

OBJECTIVE. The prognosis in patients with posterior urethral valves (P UV) is related to the degree of renal insufficiency, Urinary ascites o r urinoma, congenital bladder diverticula, or severe unilateral vesico ureteral reflux has been associated with protected renal function, We present clinical and imaging findings in eight patients with PUV and u nilateral reflux who have preserved renal function. Initial and follow -up sonography, voiding cystourethrography, and nuclear imaging were r eviewed and compared with long-term serum creatinine levels. CONCLUSIO N, All eight patients had normal renal function on long-term follow-up , suggesting that unilateral reflux, which occurs in as many as 35% of boys with PUV, is associated with protected renal function. Although early nephrectomy of tile refluxing unit has been advocated for patien ts with PUV and unilateral reflux into a dysplastic kidney (the vesico ureteral reflux and renal dysplasia syndrome), we found that significa nt renal function may be present in the refluxing kidney and that func tion may even increase with time, Most of these patients did well with out nephrectomy. Therefore, a sufficient interval should elapse before nephrectomy is considered in these patients.