Muhammad Akmal Rahmani, Muhammad M Shakeel, Ishtiaq Ahmed Chaudhary.
Vesico-ureteric Reflux in Children.
J Coll Physicians Surg Pak Jan ;12(8):481-4.

Objective: To evaluate the epidemiology and outcome of the treatment of vesico-ureteric reflux. Design: A prospective study. Place and Duration of Study: This study included a total number of 30 patients at AFIU, Rawalpindi, from December 1997 to March 2000. Subjects and Methods: All the patients with less than 12 years of age with diagnosed vesico-ureteric reflux were included. Lower urinary tract was evaluated with voiding cystogram and upper urinary tract with ultrasonography and 99mTc-DMSA scan and grade of reflux was evaluated. Medical treatment was given in grade I to III while grade IV and V were treated surgically. Results: Majority of the patients (63.33%) were presented with recurrent UTI and area of renal scarring was detected in 86.66% patients and all of them having grade IV and V reflux. A total of 76.66% patients had primary reflux with female predominance and 13.33% patient were given medical treatment and 86.67% were treated surgically. In second group 88.46% patients shows no reflux postoperatively and 11.54% had persistent reflux. Stenosis was developed in 3.84% in implanted ureter and 16.66% developed UTI postoperatively. Conclusion: In grade I- III watchful waiting of primary reflux and keeping urinary tract free of infection is the mainstay of management and surgical treatment is recommended for higher grade of reflux and secondary reflux.

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