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11–14 APRIL, 2018, HELSINKI, FINLAND
09:19–09:22
S5-6 (PP)
CRITICAL ANALYSIS OF THE OUTCOME
OF PRIMARY UNILATERAL VESICOURETERAL REFLUX
IN A CONTEMPORARY SERIES
Osama SARHAN
1
, Ahmed EL HELALY
2
, Hossam EL-THOLOTH
2
,
Mustafa AL GHANBAR
2
, Abdulhakim AL OTAY
2
and Ziad NAKSHABANDI
2
1) Mansoura Urology and Nephrology Center, Urology, Mansoura, EGYPT - 2) Prince Sultan Military Medical City,
Urology, Riyadh, SAUDI ARABIA
PURPOSE
Vesicoureteral reflux (VUR) is a common finding in pediatric age with the risk of repeated urinary
tract infections and renal damage. Herein we explored the possible risk factors which affect the
resolution rate in patients with primary unilateral VUR under conservative treatment.
MATERIAL AND METHODS
We retrospectively evaluated all patients with VUR between 2006 and 2014 and only patients with
primary unilateral VUR were included. Records were reviewed for age at diagnosis, antenatal his-
tory, gender, mode of presentation, side and grade of VUR, associated hydronephrosis (HN), pres-
ence of scarring and split function on DMSA. Clinical and radiological outcomes were assessed.
Both univariate and multivariate analysis were conducted.
RESULTS
A total of 68 patients (32 boys and 36 girls) with primary unilateral VUR were included with a mean
age at diagnosis of 10 months. Antenatal HN was detected in 50 % of patients. VUR was high
grade (IV–V) in 22 patients (32 %). Associated HN was evident in 39 patients (57 %). DMSA
scans showed renal scarring in 16 patients (23 %) and a mean split function of 47 %. After a mean
follow-up of 7 years, VUR resolved in 49 patients (72 %). VUR grade, DMSA split function, and
associated high-grade HN were significant predictors for VUR resolution. On multivariate analysis,
the presence of high-grade HN with VUR was the only significant independent risk factor.
CONCLUSIONS
Resolution rate in primary unilateral VUR under conservative treatment is significantly affected by
grade of VUR, split renal function on DMSA and presence of high-grade HN. Association of high-
grade HN with VUR carries a low chance for spontaneous resolution.