As vesicoureteral reflux (VUR) progresses, renal scarring change can occur. The damage of the kidney may progress to end stage renal disease in reflux nephropathy. So, the treatment against reflux is very important, but the approaches on the treatment are still different by many authors.
We studied 107 children with urinary tract infection UTI) admitted at Young Dong Severance Hospital from April, 1983 to January, 1986.
Intravenous pyelography(IVP) were performed in boys with 1st episode of UTI and girls with 1st recurrence of UTI. Voiding cystourethrography (VCUG) were performed in children with abnormal findings on IVP and persistent, pyuria of frequent recurrence despite of normal IVP.
Vesicoureteral reflux was seen 9 boys and 11 girls.
Under 1 year of age, male infants predominate, but from I to 6 years of age, female children predominate. After that age, sex ratio was nearly
equal.
Both sides of ureters were equally affected in general, and bilaterality was seen in 8 children.
Fever, dysuria and urinary frequency were commonly associated in VUR, as the findings of general UTI patients.
In 9 patients, one or more previous UTI episodes were noticed.
Primary causes of VUR were present in 3 cases.
All cases of grade N and V VUR except 1 case who discharged against advice, and 3 cases of grade J VUR, were treated by surgical procedures. The others were treated medically except 1 case combined with ureteropelvic junctional stenosis, who recieved surgical treatment, ureteroneocystostomy was done in 10 cases, and suprapubic cystostomy was done in the others.
The follow up IVP and VCUG during the period of 3 months to 18 months, was done in 5 cases treated with ureteroneocystostomy, 2 cases treated with suprapubic cystostomy and 3 cases received medical therapy.
In cases treated with suprapubic cystostomyy refluxes continued but further renal damages were not found. And, all other cases had no more refluxes in follow up radiological studies.
We strongly suggest the aggressive approach to find out urinary tract abnormalities in UTI children.
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