CLINICAL-FEATURES OF VESICOURETERAL REFLUX IN INFANTS AND OUTCOME OF CONSERVATIVE THERAPEUTIC APPROACH

Objectives: We evaluated the clinical features of vesicoureteral reflu x (VUR) detected in infants and the outcome of a conservative therapeu tic approach. Methods: Consecutively 67 infants with VUR (55 boys and 12 girls) were enrolled in this study. Of the 67 patients, 34 had prim ary and 33 had secondary VUR. Underlying abnormalities in secondary VU R were: posterior urethral valve (PUV) in 7; bulbar urethral stenosis (Cobb's collar) in 16; neurovesical dysfunction (NVD) in 8, and others in 2. Transurethral incision was performed in patients with PUV or Co bb's collar. NVD was managed with intermittent catheterization. All pa tients were followed with antibiotic prophylaxis. Results: No signific ant difference was found in VUR grades between primary and secondary V UR. Spontaneous resolution of VUR was noted in 31% of primary and 54% of secondary VUR (p < 0.02). VUR downgrading including VUR resolution was also noted more often in secondary than in primary VUR (80 vs. 48% ; p < 0.01). Conclusions: The distribution of primary and secondary VU R in infants was almost equal in our study. Resolution of reflux is se en more often in secondary than in primary cases, Thus, early detectio n and proper management of underlying lower urinary tract abnormalitie s, either structural or functional, are crucial in the treatment of VU R in infants.