ABSTRACT
Primary vesico-ureteric reflux (VUR) is the most common urological anomaly in children and has been reported in 30-50 percent of those who present with urinary tract infection (UTI). The association of VUR, UTI and renal parenchymal damage is well established. Reflux nephropathy is present in 3-25 percent of children and in 10-15 percent of adults with end-stage renal failure. There has been no consensus regarding when medical or surgical therapy should be used. A number of prospective studies have shown low rates of spontaneous resolution of high-grade reflux. Moreover, observation alone carries a risk of renal scarring. Ureteric re-implantation by open surgery on the bladder is effective in curing reflux, but the operation is not free of complications, and its indications are disputed.
