ABSTRACT

Primary vesicoureteral 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 known. Reflux nephropathy is recognized as a major cause of end-stage renal failure in children and young adults. Primary VUR is caused by congenital absence or deficiency of the longitudinal muscle of the submucosal ureters. This results in upward and lateral displacement of the ureteric orifice during micturition, thereby reducing the length and obliquity of the submucosal ureter. There has been no consensus regarding when medical or surgical therapy should be used. A number of prospective studies have shown low probability of spontaneous resolution of high grade of reflux during conservative follow-up. Furthermore, all of these studies revealed that observation therapy does carry an ongoing risk of renal scarring.