engleski

Spontaneous Resolution Of Primary Vesicoureteral Reflux Diagnosed In The First Year Of Life And Renal Outcome Evaluted With Tubular Scintigraphy

Introduction: A retrospective study was performed to study spontaneous resolution of primary vesicoureteral reflux (VUR) in infants and renal outcome analysed with tubular scintigraphy. Medical records of 161 infants, presenting at our institution in 3 year period were reviewed. Material and methods: There were 68 males and 93 females, with mean age at diagnosis of 4.47±4.0 months. The majority of infants with VUR, 155/161, presented with one or more episodes of urinary tract infection. Diagnosis was established using radiographic voiding cystourethrogram. At diagnosis, a renal ultrasound and renal scintigraphy with Tc-99m- DMSA were performed in all children and data of scintigraphy were determined as normal, equivocal or pathologic findings. The follow-up included serial urine cultures, haematological and biochemical tests, radiographic cystography, renal ultrasound and renal tubular scintigraphy. Results: Out of 161 children with 260 refluxing units (RU), VUR resolved spontaneously in 122 children (75.77%) with 203 RU, 4 children with 6 RU underwent endoscopic correction. Spontaneous resolution after uroprophylaxis was more frequent in boys (p < 0.001), in VUR grade I or II (p < 0.0001) and bilateralVUR at diagnosis (p< 0, 001).Mean age of VUR resolution was 23.2 ± 9.47 months. The first renal scintigraphy was normal in 97 (37.5%), equivocal in 137 (52.5%) and pathologic in 26 (10.0 %). In comparison with the first scans more normal findings (139 kidneys ; 53.5%) and less equivocal findings (91 kidneys ; 34.9%) were found on the final scintigrams (p<0, 01). The percentages of pathologic findings were similar on the first and the last scans (26 kidneys ; 10.0 % vs 30 kidneys ; 11.6 %). Conclusions: The data of the study indicate that spontaneous VUR resolution rate is high in infants. Similar percentages of pathologic findings on the first and the last scintigraphy points to the beneficial influence of uroprophylaxis in preventing further renal damage.

spontaneous resolution; vecicoureteral reflux; t ubular scintigraphy

nije evidentirano