We performed a retrospective review to evaluate the result of the management on primary vesicoureteral reflux in 36 children (59 refluxing ureters) during a 11-year period (1980 to 1990). Based upon the international classification. the
vesicoureteral
reflux was grade I in 6 cases (11.1%), grade II in 14(23.7%), grade III in 13(22.1%), grade IV in 15(25.4%) and grade V in 11 (18.6%) and designed to compare the risk or benefit of medical and surgical treatment as initial management for this.
The
group
of primary medical management included with total 42 ureters and as the results of the management the reflux was completely disappeared in average 8.2 months at 22 ureters and 13 ureters were secondarily operated because of progressed reflux or
recurrent urinary tract infection despite of appropriate medical treatment. The group of primary surgical management included with 3 ureters of grade III, 7 in grade IV, 7 of grade V, total 17 ureters and then 1 ureter of which was reoperated due
to
progressed reflux, but all reflux were cured. And we checked the 99m technetium-dimercapto-succinic acrd renal scan to detect renal scars at pre-treatment in 33 ureters(22 patients) and post-treatment in 21 ureters (14 patients). As the results,
the
renal scars were detected in 17 ureters at pre-treatment patients. And during follow up, there were no changes of the renal scar at post-treatment in 18 ureters, but a new scar was developed in 3 ureters (grade II in 1, grade IV in 2) even though
having
medical treatment. The radionuclide renal scan was highly sensitive to detect the scar, so should be performed.
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