Vesicoureteral reflux: current concepts and management implications.

Long term controlled studies in children with vesicoureteral reflux (VUR) largely conducted in developed societies, challenge the validity of established management principles.The backflow of urine into the upper tracts is not a disease by itself, but part of a clinical spectrum which is heterogeneous and has low risk and high risk categories. Management, medical, endoscopic or surgical have to take into consideration the risk to the child not only from the reflux but also from renal dysplasia and voiding dysfunction which are important risk factors for end stage renal disease (ESRD) and perpetuation of VUR respectively. Social factors, parental choices and access to medical treatment are also important in choosing therapy.