Sun, 09/12/2010 - 07:07 | by admin

Spontaneous resolution

As the child with VUR grows and develops, spontaneous resolution of the condition may occur.

In mild cases of VUR (grades I–III), an annual spontaneous resolution rate of 13% has been reported during the first five years of presentation.1 Children with more severe reflux have an increased risk of complications, but the likelihood of resolution is considerably lower. The corresponding resolution rate for grades IV–V was 5% yearly during the first five years of VUR presentation.1

 In a study of 149 children investigating the progress of VUR grade III or IV, 52% were shown to be free from reflux after ten years. Therefore, antibiotic prophylaxis may be needed for a significant number of years in nearly half of the patients in order to protect them from a UTI while their VUR persists.2 During this time, regular VCUGs are required to assess the condition. Also, the child is still at risk of breakthrough infections despite ongoing antibiotic treatment.

 

AUA Resolution chart (opens in a new window) »

 

  1. Schwab CW, Jr., Wu HY, Selman H, et al. Spontaneous resolution of vesicoureteral reflux: a 15-year perspective. J Urol 2002; 168: 2594-9.
  2. Smellie JM, Jodal U, Lax H, et al. Outcome at 10 years of severe vesicoureteric reflux managed medically: Report of the International Reflux Study in Children. J Pediatr 2001; 139: 656-63.

 

Chart references

Jack S. Elder, MD; Craig Andrew Peters, MD; Billy S. Arant, Jr., MD; David H. Ewalt, MD; Charles E. Hawtrey, MD; Richard S. Hurwitz, MD; Thomas S. Parrott, MD; Howard M. Snyder, III, MD; Robert A. Weiss, MD. AUA Pediatric Vesicoureteral Reflux Clinical Guidelines Panel: The Management of Primary Vesicoureteral Reflux in Children. American Urological Association Education and Research, Inc., © 1997. 5/2006: http://www.auanet.org/timssnet/products/guidelines/main_reports/vesi_ref...