A follow‐up study of pre‐natally detected primary vesico‐ureteric reflux: a review of 61 patients

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Abstract
Objective To describe the pre‐ and post‐natal characteristics of primary vesico‐ureteric reflux (VUR) in a retrospective study of babies presenting with VUR suspected from pre‐natal ultrasonography. Patients and methods Between 1984 and 1994, 61 children (41 boys and 20 girls) with primary VUR were followed for 2 years after the pre‐natal detection of urinary tract anomalies. Patients with VUR secondary to infravesical obstruction and duplex systems were excluded. The mean age at ante‐natal diagnosis was 28.4 weeks of gestation; in 37 the reflux was bilateral and 98 refluxing units were reviewed. Results According to the international classification of VUR, 8% were grade 1, 32% grade 2, 38% grade 3, 16% grade 4 and 6% grade 5. Twelve patients (22 refluxing units) underwent ureteric re‐implantation. Six kidneys showed renal scars on isotope renography and two nephrectomies were carried out in patients <2 years old; in 40 patients (64 renal units) the VUR resolved spontaneously. Of the latter, eight were grade 1, 20 grade 2, 27 grade 3 and nine grade 4; seven patients (10 refluxing units) are still being followed and awaiting a decision on treatment. Conclusion This study confirms the predominance of boys in those with ante‐natally suspected VUR. The spontaneous resolution during the first 2 years of life was apparent in most cases, even in those with severe reflux (grade 3–5).

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