The management of vesicoureteral reflux in children
Keywords:
vesicoureteral reflux, VUR, retrograde flow, urinary tract infection, UTI
Abstract
Vesicoureteral reflux (VUR) is defined as retrograde flow of urine from the bladder to the ureter. Â It is usually asymptomatic but commonly found in children with urinary tract infection (UTI). The prevalence is about 1-2% in general pediatric population.1 However, the prevalence in children with UTI is much higher, reaching 30-57%.1,2 Similar prevalence (45.8%) is also reported in CiptoMangunkusumo Hospital. 3
References
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2. Khoury A, Bagli DJ. Reflux and Megaureter. In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA, editors. Campbell-Walsh Urology. 9th ed. Philadelphia: Elsevier;
2007. p. 9032-170.
3. Sihombing R. Refluks Vesikoureter Dengan Dan Tanpa N efropati Refluks Pada Anak Dengan Infeksi Saluran Kemih. Jakarta: Universitas Indonesia; 1998.
4. Gordon I, Barkovics M, Pindoria S, Cole TJ, Woolf AS. 266 • Paediatr Indones, Vol. 50, No.5, September 2010 Primary Vesicoureteric Reflux as a Predictor of Renal Damage in Children Hospitalized 'With Urinary Tract Infection: A Systematic Review and Metaô€›Analysis. J Am Soc Nephrol 2003;14:739-44.
5. Sharbaf FG, Fallahzadeh MH, Modarresi AR, Esmaeili M. Primary Vesicoureteral Reflux in Iranian Children. Indian Pediatrics 2007;44:128-30.
6. Roehrborn CG, McConnell JD. Reflux and Megaureter.In: Wein AJ, editor. Campbell Urology. 9 ed. Philadelphia:Elsevier; 2002.
7. Santoso A, Tarmono, Santosa A, Rodjani A, Safriadi F. Refluks. In: Guidelines Pediatrik Urologi. Jakarta: Ikatan Ahli Urologi Indonesia; 2007. p. 15-22.
8. Nemett DR, Fivush BA, Mathews R, Camirand N, Eldridge MA, Finney K, et al. A randomized controlled trial of the effectiveness of osteopathy-based manual physical therapy in treating pediatric dysfunctional voiding. Journal of Pediatric Urology 2007;4:100-6.
9. Bagga A, Had P. Vesicouretedc Reflux and Reflux Nephropathy. In: Bagga A, editor. New Delhi: Indian Pediatrics; 1998.
10. Garin EH, Olavarria F, Nieto VG, Valenciano B, Campos A, Young L. Clinical Significance of Primary Vesicoureteral Reflux and Urinary Antibiotic Prophylaxis After Acute Pyelonephritis: A Multicenter, Randomized, Controlled Study. Pediatrics 2006;117:626-32.
11. Keren R, Carpenter MA, Hoberman A, Shaikh N, Matoo T K , Chesney RW, et al. Rationale and Design Issues of the Randomized Intervention for Children With Vesicoureteral Reflux (RIVUR) Study. Pediatrics 2008;122:S240-S250.
12. Goonasekera CDA, Dillon MJ. Hypertension in reflux nephropathy. BJU International 1999;83:1-12.
13. Barai S, Bandopadhayaya Gp, Bhowmik D, Patel CD, Malhotra A, Agarwal P, et al. Prevalence of Vesicoureteral Reflux In Patients With Incidentally Diagnosed Adult Hypertension. Urology 2004;63:1045-8.
14. Kohler J, Tencer J, T hysell H, Forsberg L. Vesicoureteral reflux diagnosed in adulthood. Incidence of urinary tract infections, hypertension, proteinuria, back pain and renal calculi. Nephrol Dial Transplant 1997;12:258-7.
15. Goonasekera CDA, Dillon MJ. Reflux nephropathy and hypertension. Journal of Human Hypertension 1998;12:497-504.
16. Kohler JR, Tencer J, T hysell H, Forsberg L, Hellstrom M. Long-Term Effects of Reflux Nephropathy on Blood Pressure and Renal Function in Adults. Nephron Clin Pract 2002;93:c35-c46.
17. Silva ACSe, Silva JMP, Dinh JSS, Pinheiro SVB, Lima EM, Vasconcelos MA, et al. Risk of hypertension in primary vesicoureteral reflux. Pediatr Nephrol 2007;22:459-62.
18. Silva JMP, Oliveira EA, Diniz JSS, Bouzada MCF, Vergara RM, Souza BC. Clinical course of prenatally detected primary vesicoureteral reflux. Pediatr Nephrol 2006;21 :86-91.
19. Silva jMP, Dinh JSS, Marino YSp, Lima EM, Cardoso LSB, Vasconcelos MA, et al. Clinical course of 735 children and adolescents with primary vesicoureteral reflux. Pediatr N ephrol 2006;21:981-8.
20. Naseer SR, Steinhardt GF. New Renal Scars In Children With Urinary Tract Infections, Vesicoureteral Reflux And Voiding Dysfunction: A Prospective Evaluation. Journal of Urology 1997 ;158:566-8.
21. Snodgrass W. Relationship Of Voiding Dysfunction To Urinary Tract Infection And Vesicoureteral Reflux In Children. Pediatric Urology. 1991;38:341-4.
22. Sillen U. Bladder Dysfunction and Vesicoureteral Reflux. Advances in Urology 2008:1-8.
23. Chamie K, Chi A, Hu B, Keegan KA, Kurzrock EA. Contemporary Open Ureteral Reimplantation Without Morphine: Assessment of Pain and Outcomes. Journal of Urology 2009;182:1147-1151.
24. Jodal U, Smellie JM, Lax H, Hoyer PF. Ten-year results of randomized treatment of children 'With severe vesicoureteral reflux. Final report of the International Reflux Study in Children. Pediatric Nephrology 2006;21:785-92.
25. Fanos V, Cataldi L. Antibiotics or surgery for vesicoureteric reflux in children. Lancet 2004;364:1720-22.
26. Zaffanello M, Franchini M, Brugnara M, Fanos V. Evaluating Kidney Damage from Vesicoô€²Ureteral Reflux in Children. Saudi Journal of Kidney Diseases and Transplantation 2009;20:57-68.
27. Chung PHY, Lan LCL, Wong KKY, Tam PKH. Deflux Injection for the Treatment of Vesicoureteric Reflux in Children-A Single Centre's Experience. Asian J Surg 2009;32:163-6.
28. Bouissou F, Munzer C, Decramer S, Roussel B, Novo R, Morin D, et al. Prospective, Randomized Trial Comparing Short and Long Intravenous Antibiotic Treatment of Acute Pyelonephritis in Children: Dimercaptosuccinic Acid Scintigraphic Evaluation at 9 Months. Pediatrics 2008;121:e55 3-e560.
29. Neuhaus TJ, Berger C, Buechner K, Parvex P, Bischoff G, Goetschel P, et al. Randomised trial of oral versus sequential intravenous/oral cephalosporins in children
with pyelonephritis. European Journal of Pediatrics 2007 ;167:1037-47.
30. Lee Sj, Shim YH, Cho Sj, Lee jW Probiotics prophylaxis in children with persistent primary vesicoureteral reflux. Pediatr NephroI2007;22:1315-20.
31. Pennesi M, Travan L, Peratoner L, Bordugo A, Cattaneo A, Ronfani L, et al. Is antibiotic prophylaxis in children with vesicoureteral reflux effective in preventing pyelonephritis and renal scars? A randomized, controlled trial. Pediatrics 2008; 121:e1489-e1494.
32. Montini G, Rigon L, Zucchetta P, Fregonese F, Toffolo A, Gobber D, et al. Prophylaxis After First Febrile Urinary Tract Infection in Children? A Multicenter, Randomized, Controlled, Noninferiority Trial. Pediatrics 2008;122:1064-71.
33. Roussey-Kesler G, V. Gadjos NI, Horen B, Ichay L, Leclair MD, Raymond F, et al. Antibiotic Prophylaxis for the Prevention of Recurrent Urinary Tract Infection in Children
With Low Grade Vesicoureteral Reflux: Results From a Prospective Randomized Study. THE JOURNAL OF UROLOGY 2008; 179:674-679.
34. Nelson Cp, Copp HL, Lai j, Saigal CS. Is Availability of Endoscopy Changing Initial Management of Vesicoureteral Reflux? journal of Urology 2009;182:1152-7.
35. Simforoosh N, Hariri H. Management of vesicoureteral reflux without indwelling catheter and drain, using trigonoplasty technique. Journal of Pediatric Urology 2008;4:445-7.
36. Onnaechea M, Ruiz E, Denes E, Gimenez F, F T Denes, Moldes J, et al. New Tissue Bulking Agent (Polyacrylate Polyalcohol) for Treating Vesicoureteral Reflux: Preliminary Results in Children. journal of Urology 2010;183:714-8.
37. Molitierno JA, Scherz HC, Kirsch AJ. Endoscopic injection of dextranomer hyaluronic acid copolymer for the treatment of vesicoureteral reflux in duplex ureters. Journal of Pediatric Urology 2008;4:372-6.
38. Dave S, Loremo Aj, Khoury AE, Braga LHP, Ske!don SJ, Suoub M, et al. Learning From the Learning Curve: Factors Associated With Successful Endoscopic Correction of Vesicoureteral Reflux Using Dextranomer/Hyaluronic Acid Copolymer. journal of Urology 2008;180:1594-1600.
39. Lee EK, Gatti JM, DeMarco RT, Murphy JP. Long-Term Followup of Dextranomer!Hyaluronic Acid Injection for Vesicoureteral Reflux: Late Failure Warrants Continued Followup. journal of Urology 2009;181:1869-75.
40. Gargollo PC, Paltie! Hj, Rosoklija I, Diamond DA. Mound Calcification After Endoscopic Treatment of Vesicoureteral Reflux With Autologous Chondrocytes-A Normal Variant of Mound Appearance? Journal of Urology 2009;181:2702-8.
41. Yalla JS, Steyaert H, Griffin Sj, Lamon J, FragosoAC, Arnaud P, et al. Transvesicoscopic Cohen ureteric reimplantation for vesicoureteral reflux in children: A single-centre 5-year experience. Journal of Pediatric Urology 2009;5 :466-71.
42. Somogyi R, Oberritter Z, Juhasz Z, Vajda P, Pinter AB. Combination of vesicoureteric reflux and vesicoureteric junction obstruction. Scandinavian Journal of Urology and Nephrology 2009;43:501-5.
43. Schwentner C, Oswald J, Lunacek A, Deibl M, Koerner I, Bartsch G, et al. Lich-Gregoir Reimplantation Causes Less Discomfort than Politano-Leadbetter Technique: Results of a Prospective, Randomized, Pain Scale-Oriented Study in a Pediatric Population. European Urology 2006;49:388-95.
44. Mor Y, Leibovitch I, Zalts R, Lotan D, Jonas P, Ramon J. Analysis of the long-term outcome of surgically corrected vesicoô€“ureteric reflux. BJU International 2003 ;92:97- 100.
45. Ashley R, Vandersteen D. Mini-Ureteroneocystostomy: A Safe and Effective Outpatient Treatment for Unilateral Vesicoureteral Reflux. Journal of Urology 2008;180:1621-5
46. Ashley R, Vandersteen D. Outcome Analysis of Mini-Ureteroneocystostomy Versus Dextranomer/Hyaluronic Acid Copolymer Injection for Unilateral Vesicoureteral Reflux. Journal of Urology 2008;180;1611-4.
47. Hinman F. Ureteral Reconstruction and Excision. In: Atlas of Urologic Surgery. 2 ed. Philadelphia: WB. Saunders Company; 1998. p. 818-821.
48. Lama G, Tedesco MA, Graziano L, Calabrese E, Grassia C, Natale F, et al. Reflux nephropathy and hypertension: correlation with the progression of renal damage. Pediatr NephroI2003;18:241-5.
49. Nielsen JB, Frekiar J, Rehling M, Jergensen TM, Djurhuus JC. A 14-year follow-up of conservative treatment for vesico-ureteric reflux. BJU International 2000;86:502-7.
50. Faust WC, Pohl HG. Role of prophylaxis in vesicoureteral reflux. CUff Opin UroI2007;17:252-6.
2. Khoury A, Bagli DJ. Reflux and Megaureter. In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA, editors. Campbell-Walsh Urology. 9th ed. Philadelphia: Elsevier;
2007. p. 9032-170.
3. Sihombing R. Refluks Vesikoureter Dengan Dan Tanpa N efropati Refluks Pada Anak Dengan Infeksi Saluran Kemih. Jakarta: Universitas Indonesia; 1998.
4. Gordon I, Barkovics M, Pindoria S, Cole TJ, Woolf AS. 266 • Paediatr Indones, Vol. 50, No.5, September 2010 Primary Vesicoureteric Reflux as a Predictor of Renal Damage in Children Hospitalized 'With Urinary Tract Infection: A Systematic Review and Metaô€›Analysis. J Am Soc Nephrol 2003;14:739-44.
5. Sharbaf FG, Fallahzadeh MH, Modarresi AR, Esmaeili M. Primary Vesicoureteral Reflux in Iranian Children. Indian Pediatrics 2007;44:128-30.
6. Roehrborn CG, McConnell JD. Reflux and Megaureter.In: Wein AJ, editor. Campbell Urology. 9 ed. Philadelphia:Elsevier; 2002.
7. Santoso A, Tarmono, Santosa A, Rodjani A, Safriadi F. Refluks. In: Guidelines Pediatrik Urologi. Jakarta: Ikatan Ahli Urologi Indonesia; 2007. p. 15-22.
8. Nemett DR, Fivush BA, Mathews R, Camirand N, Eldridge MA, Finney K, et al. A randomized controlled trial of the effectiveness of osteopathy-based manual physical therapy in treating pediatric dysfunctional voiding. Journal of Pediatric Urology 2007;4:100-6.
9. Bagga A, Had P. Vesicouretedc Reflux and Reflux Nephropathy. In: Bagga A, editor. New Delhi: Indian Pediatrics; 1998.
10. Garin EH, Olavarria F, Nieto VG, Valenciano B, Campos A, Young L. Clinical Significance of Primary Vesicoureteral Reflux and Urinary Antibiotic Prophylaxis After Acute Pyelonephritis: A Multicenter, Randomized, Controlled Study. Pediatrics 2006;117:626-32.
11. Keren R, Carpenter MA, Hoberman A, Shaikh N, Matoo T K , Chesney RW, et al. Rationale and Design Issues of the Randomized Intervention for Children With Vesicoureteral Reflux (RIVUR) Study. Pediatrics 2008;122:S240-S250.
12. Goonasekera CDA, Dillon MJ. Hypertension in reflux nephropathy. BJU International 1999;83:1-12.
13. Barai S, Bandopadhayaya Gp, Bhowmik D, Patel CD, Malhotra A, Agarwal P, et al. Prevalence of Vesicoureteral Reflux In Patients With Incidentally Diagnosed Adult Hypertension. Urology 2004;63:1045-8.
14. Kohler J, Tencer J, T hysell H, Forsberg L. Vesicoureteral reflux diagnosed in adulthood. Incidence of urinary tract infections, hypertension, proteinuria, back pain and renal calculi. Nephrol Dial Transplant 1997;12:258-7.
15. Goonasekera CDA, Dillon MJ. Reflux nephropathy and hypertension. Journal of Human Hypertension 1998;12:497-504.
16. Kohler JR, Tencer J, T hysell H, Forsberg L, Hellstrom M. Long-Term Effects of Reflux Nephropathy on Blood Pressure and Renal Function in Adults. Nephron Clin Pract 2002;93:c35-c46.
17. Silva ACSe, Silva JMP, Dinh JSS, Pinheiro SVB, Lima EM, Vasconcelos MA, et al. Risk of hypertension in primary vesicoureteral reflux. Pediatr Nephrol 2007;22:459-62.
18. Silva JMP, Oliveira EA, Diniz JSS, Bouzada MCF, Vergara RM, Souza BC. Clinical course of prenatally detected primary vesicoureteral reflux. Pediatr Nephrol 2006;21 :86-91.
19. Silva jMP, Dinh JSS, Marino YSp, Lima EM, Cardoso LSB, Vasconcelos MA, et al. Clinical course of 735 children and adolescents with primary vesicoureteral reflux. Pediatr N ephrol 2006;21:981-8.
20. Naseer SR, Steinhardt GF. New Renal Scars In Children With Urinary Tract Infections, Vesicoureteral Reflux And Voiding Dysfunction: A Prospective Evaluation. Journal of Urology 1997 ;158:566-8.
21. Snodgrass W. Relationship Of Voiding Dysfunction To Urinary Tract Infection And Vesicoureteral Reflux In Children. Pediatric Urology. 1991;38:341-4.
22. Sillen U. Bladder Dysfunction and Vesicoureteral Reflux. Advances in Urology 2008:1-8.
23. Chamie K, Chi A, Hu B, Keegan KA, Kurzrock EA. Contemporary Open Ureteral Reimplantation Without Morphine: Assessment of Pain and Outcomes. Journal of Urology 2009;182:1147-1151.
24. Jodal U, Smellie JM, Lax H, Hoyer PF. Ten-year results of randomized treatment of children 'With severe vesicoureteral reflux. Final report of the International Reflux Study in Children. Pediatric Nephrology 2006;21:785-92.
25. Fanos V, Cataldi L. Antibiotics or surgery for vesicoureteric reflux in children. Lancet 2004;364:1720-22.
26. Zaffanello M, Franchini M, Brugnara M, Fanos V. Evaluating Kidney Damage from Vesicoô€²Ureteral Reflux in Children. Saudi Journal of Kidney Diseases and Transplantation 2009;20:57-68.
27. Chung PHY, Lan LCL, Wong KKY, Tam PKH. Deflux Injection for the Treatment of Vesicoureteric Reflux in Children-A Single Centre's Experience. Asian J Surg 2009;32:163-6.
28. Bouissou F, Munzer C, Decramer S, Roussel B, Novo R, Morin D, et al. Prospective, Randomized Trial Comparing Short and Long Intravenous Antibiotic Treatment of Acute Pyelonephritis in Children: Dimercaptosuccinic Acid Scintigraphic Evaluation at 9 Months. Pediatrics 2008;121:e55 3-e560.
29. Neuhaus TJ, Berger C, Buechner K, Parvex P, Bischoff G, Goetschel P, et al. Randomised trial of oral versus sequential intravenous/oral cephalosporins in children
with pyelonephritis. European Journal of Pediatrics 2007 ;167:1037-47.
30. Lee Sj, Shim YH, Cho Sj, Lee jW Probiotics prophylaxis in children with persistent primary vesicoureteral reflux. Pediatr NephroI2007;22:1315-20.
31. Pennesi M, Travan L, Peratoner L, Bordugo A, Cattaneo A, Ronfani L, et al. Is antibiotic prophylaxis in children with vesicoureteral reflux effective in preventing pyelonephritis and renal scars? A randomized, controlled trial. Pediatrics 2008; 121:e1489-e1494.
32. Montini G, Rigon L, Zucchetta P, Fregonese F, Toffolo A, Gobber D, et al. Prophylaxis After First Febrile Urinary Tract Infection in Children? A Multicenter, Randomized, Controlled, Noninferiority Trial. Pediatrics 2008;122:1064-71.
33. Roussey-Kesler G, V. Gadjos NI, Horen B, Ichay L, Leclair MD, Raymond F, et al. Antibiotic Prophylaxis for the Prevention of Recurrent Urinary Tract Infection in Children
With Low Grade Vesicoureteral Reflux: Results From a Prospective Randomized Study. THE JOURNAL OF UROLOGY 2008; 179:674-679.
34. Nelson Cp, Copp HL, Lai j, Saigal CS. Is Availability of Endoscopy Changing Initial Management of Vesicoureteral Reflux? journal of Urology 2009;182:1152-7.
35. Simforoosh N, Hariri H. Management of vesicoureteral reflux without indwelling catheter and drain, using trigonoplasty technique. Journal of Pediatric Urology 2008;4:445-7.
36. Onnaechea M, Ruiz E, Denes E, Gimenez F, F T Denes, Moldes J, et al. New Tissue Bulking Agent (Polyacrylate Polyalcohol) for Treating Vesicoureteral Reflux: Preliminary Results in Children. journal of Urology 2010;183:714-8.
37. Molitierno JA, Scherz HC, Kirsch AJ. Endoscopic injection of dextranomer hyaluronic acid copolymer for the treatment of vesicoureteral reflux in duplex ureters. Journal of Pediatric Urology 2008;4:372-6.
38. Dave S, Loremo Aj, Khoury AE, Braga LHP, Ske!don SJ, Suoub M, et al. Learning From the Learning Curve: Factors Associated With Successful Endoscopic Correction of Vesicoureteral Reflux Using Dextranomer/Hyaluronic Acid Copolymer. journal of Urology 2008;180:1594-1600.
39. Lee EK, Gatti JM, DeMarco RT, Murphy JP. Long-Term Followup of Dextranomer!Hyaluronic Acid Injection for Vesicoureteral Reflux: Late Failure Warrants Continued Followup. journal of Urology 2009;181:1869-75.
40. Gargollo PC, Paltie! Hj, Rosoklija I, Diamond DA. Mound Calcification After Endoscopic Treatment of Vesicoureteral Reflux With Autologous Chondrocytes-A Normal Variant of Mound Appearance? Journal of Urology 2009;181:2702-8.
41. Yalla JS, Steyaert H, Griffin Sj, Lamon J, FragosoAC, Arnaud P, et al. Transvesicoscopic Cohen ureteric reimplantation for vesicoureteral reflux in children: A single-centre 5-year experience. Journal of Pediatric Urology 2009;5 :466-71.
42. Somogyi R, Oberritter Z, Juhasz Z, Vajda P, Pinter AB. Combination of vesicoureteric reflux and vesicoureteric junction obstruction. Scandinavian Journal of Urology and Nephrology 2009;43:501-5.
43. Schwentner C, Oswald J, Lunacek A, Deibl M, Koerner I, Bartsch G, et al. Lich-Gregoir Reimplantation Causes Less Discomfort than Politano-Leadbetter Technique: Results of a Prospective, Randomized, Pain Scale-Oriented Study in a Pediatric Population. European Urology 2006;49:388-95.
44. Mor Y, Leibovitch I, Zalts R, Lotan D, Jonas P, Ramon J. Analysis of the long-term outcome of surgically corrected vesicoô€“ureteric reflux. BJU International 2003 ;92:97- 100.
45. Ashley R, Vandersteen D. Mini-Ureteroneocystostomy: A Safe and Effective Outpatient Treatment for Unilateral Vesicoureteral Reflux. Journal of Urology 2008;180:1621-5
46. Ashley R, Vandersteen D. Outcome Analysis of Mini-Ureteroneocystostomy Versus Dextranomer/Hyaluronic Acid Copolymer Injection for Unilateral Vesicoureteral Reflux. Journal of Urology 2008;180;1611-4.
47. Hinman F. Ureteral Reconstruction and Excision. In: Atlas of Urologic Surgery. 2 ed. Philadelphia: WB. Saunders Company; 1998. p. 818-821.
48. Lama G, Tedesco MA, Graziano L, Calabrese E, Grassia C, Natale F, et al. Reflux nephropathy and hypertension: correlation with the progression of renal damage. Pediatr NephroI2003;18:241-5.
49. Nielsen JB, Frekiar J, Rehling M, Jergensen TM, Djurhuus JC. A 14-year follow-up of conservative treatment for vesico-ureteric reflux. BJU International 2000;86:502-7.
50. Faust WC, Pohl HG. Role of prophylaxis in vesicoureteral reflux. CUff Opin UroI2007;17:252-6.
Published
2010-10-30
How to Cite
1.
Akbar N, Rodjani A. The management of vesicoureteral reflux in children. PI [Internet]. 30Oct.2010 [cited 25Nov.2024];50(5):259-8. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/994
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Received 2016-10-31
Accepted 2016-10-31
Published 2010-10-30
Accepted 2016-10-31
Published 2010-10-30
