Predictive Factors of Early Spontaneous Resolution in Children With Primary Vesicoureteral Reflux
- 31 October 2007
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of Urology
- Vol. 178 (4S), 1684-1688
- https://doi.org/10.1016/j.juro.2007.03.161
Abstract
Purpose: Questions regarding the efficacy and safety of long-term prophylactic antibiotics and the option of minimally invasive therapy have increased clinical emphasis on predicting early resolution in patients with vesicoureteral reflux. We reviewed multiple potential prognostic factors in addition to grade to enhance predictive ability regarding early vesicoureteral reflux resolution. Materials and Methods: Medical records and cystograms from 324 children (257 girls and 67 boys) with primary vesicoureteral reflux were reviewed. Multiple factors were analyzed with respect to outcome and multivariable dependent tables were constructed to enhance the prediction of vesicoureteral reflux resolution. Results: Mean ± SD age at diagnosis was 2.3 ± 2.1 years and followup was 1.7 ± 2.8 years. Reflux grade was significantly associated with resolution (p <0.001). Multivariate analysis stratifying by grade demonstrated that a bladder volume at reflux onset on the initial cystogram of greater than 50% of predicted bladder capacity (p <0.001), age younger than 2 years at diagnosis (p = 0.003) and history of prenatal hydronephrosis (p <0.001) were significant factors predicting resolution within 2 years. Multivariable tables using age, bladder volume at reflux onset and grade demonstrated that children younger than 2 years at diagnosis and volume at onset greater than 50% of predicted bladder capacity had a higher early resolution rate for grades 2 (p = 0.012) and 3 (p <0.001) reflux. Conclusions: Initial reflux grade, bladder volume at reflux onset, age at diagnosis and history of prenatal hydronephrosis were shown to be independent factors affecting the resolution rates of vesicoureteral reflux. The multivariable tables permit improved individualized prediction of resolution in patients with grades 2 and 3 reflux.Keywords
This publication has 19 references indexed in Scilit:
- 15. A Prospective Trial of Operative versus Non-Operative Treatment of Severe Vesico-Ureteric Reflux: 2 Years Observation in 96 Children1Published by S. Karger AG ,2015
- Bladder Volume at Onset of Reflux on Initial Cystogram Predicts Spontaneous ResolutionJournal of Urology, 2006
- Clinical Significance of Primary Vesicoureteral Reflux and Urinary Antibiotic Prophylaxis After Acute Pyelonephritis: A Multicenter, Randomized, Controlled StudyPediatrics, 2006
- THE ROLE OF ENDOSCOPIC TREATMENT OF VESICOURETERAL REFLUX: A 17-YEAR EXPERIENCEJournal of Urology, 2004
- LONG-TERM FOLLOWUP OF CHILDREN TREATED WITH DEXTRANOMER/HYALURONIC ACID COPOLYMER FOR VESICOURETERAL REFLUXJournal of Urology, 2001
- Pediatric Vesicoureteral Reflux Guidelines Panel Summary Report on the Management of Primary Vesicoureteral Reflux in ChildrenJournal of Urology, 1997
- Commentary: Management of Children with Severe Vesicoureteral RefluxJournal of Urology, 1992
- Surgical Results: International Reflux Study in Children—United States BranchJournal of Urology, 1992
- Prospective trial of operative versus non-operative treatment of severe vesicoureteric reflux in children: five years' observation. Birmingham Reflux Study Group.BMJ, 1987
- International system of radiographic grading of vesicoureteric refluxPediatric Radiology, 1985