[Spontaneous resolution of vesicoureteral reflux [VUR] in Iranian children, a single center experience in 533 cases]

ABSTRACT

Experience with vesicoureteral reflux [VUR] differs in different centers and there are lots of controversies surrounding this issue. The aim of this study was to evaluate Spontaneous resolution and prognosis of the disease among Iranian children. In this case series study, 1278 children with urinary tract infection and visited at pediatric nephrology clinic in Tehran, Iran during 1999-2007 were studied. Primary VUR was found in 533 Patients. Following the diagnosis, the patients received prophylactic antibiotic and were annually followed with radionucleo cystography [RNC]. Patients underwent surgery in case the medical treatment failed [breakthrough infection] or new renal scar formation. 533 patients with VUR were studied. Patients' mean age with VUR was 3.7 +/- 2.4 years [range 2 days to 18 years old]. During an average follow-up duration of 3.3 +/- 2.2 years, spontaneous resolution was observed in 40% of 279 patients who had follow-up RNCs. The mean interval between VUR diagnosis and spontaneous resolution was 1.5 +/- 1 years [range 2 months to 6 years]. The resolution rate was decreased with increment of reflux grade so that for grades I to V, VUR was resolved in 63%, 57%, 27%, 22% and 10% of the cases, respectively. Anti reflux surgery was performed in 27[10%] of patients during follow-up. Based on the excellent results obtained from clinical therapy using low dose antibiotics, it is recommended that VUR grades 1 to 4 be managed medically with low-dose oral antibiotic prophylaxis and close follow-ups