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Advances in Urology
Volume 2008, Article ID 437560, 5 pages
http://dx.doi.org/10.1155/2008/437560
Review Article

The Outcome of Surgery versus Medical Management in the Treatment of Vesicoureteral Reflux

Department of Urology, Children's Hospital Boston, Harvard Medical School, Boston, MA 02115, USA

Received 28 March 2008; Accepted 12 June 2008

Academic Editor: Hiep Nguyen

Copyright © 2008 Caleb P. Nelson. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Evaluation of the relative merits of medical versus surgical management of vesicoureteral reflux (VUR) has been limited by the few prospective studies comparing these strategies. Among those trials that have been reported, the only consistent positive finding has been that incidence of febrile UTI is lower among children undergoing surgical treatment in comparison with medical treatment. Studies have not found significant differences in overall incidence of UTI, or in rates of new renal scarring or progression of existing scarring. It is likely that there is a subset of children with VUR who do benefit from aggressive treatment of their VUR, but we are not yet able to fully determine which children these are. It is hoped that future research will further clarify which treatments are useful in which children.