Have we Overtreated Children with Vesicoureteric Reflux?

Abstract

Urinary tract infections (UTI) are the most common serious bacterial infections in young children. These UTIs have a high association with vesicoureteric reflux (VUR). The pathophysiology of VUR’s renal sequelae, its investigation and management is presently undergoing a reassessment. This review documents these changes focusing on compelling new data. With regard to the need for and benefit of imaging procedures in children with UTIs we present an algorithm for investigation that is tailored to the African context. The value of continuous antibiotic prophylaxis is questioned and the role of injectable ureteric bulking is discussed with reference to the Swedish Reflux Trial.

Key Words: Vesicoureteric reflux, children, etiology, pathophysiology, investigation, managment