PRIMARY VESICOURETERAL REFLUX IN IRANIAN CHILDREN:A FOLLOW-UP OF 330 CASES

Background: Experience with vesicoureteral reflux (VUR) differs in differ-ent centers and there are plenty of controversies. The aim of this study was to evaluate the outcome of primary VUR complications and the rate of recurrence of UTI. Methods: The medical charts of all infants and children with primary VUR who were followed up by two nephrologists were reviewed. During 19 years (1985-2004), 330 patients (271 females, 59 males) with 496 refluxing ureters were followed up as primary VUR. Results: The patients' age at diagnosis was 4 days to 16 years (mean: 4.1 years) and the mean duration of follow-up was 4.5 years. Urinary tract infec-tion (UTI) was the presenting symptom in 95% and fever was recorded in 35% of cases. Frequencies of different grades of VUR at initial investigation were 10%, 35%, 30%, 13% and 12% for grades I to V, respectively. Recurrence of UTI in VUR of grades I to V were 22.2%, 18.1%, 20%, 23.4% and 17.9%, re-spectively. Follow-up voiding cystourethrogram revealed resolution of VUR in 55%, improvement in 27.5%, no change in 12%, and deterioration in 5.5%. Complications such as chronic renal failure and hypertension were observed in 13 and 13 patients, respectively. Renal scarring was present in 52% of boys and 29% of girls. Conclusion: The present study indicates that symptomatic primary VUR is more common and has better prognosis in girls. Recurrence of UTI is not re-lated to the grade of VUR.