Vesicoureteral reflux in the adult. III. Surgical correction: risks and benefits.

Antireflux surgery was successful in 97 per cent of 67 adults with primary bilateral vesicoureteral reflux. Mean followup was 43 months. Of the patients 93 per cent became free of acute pyelonephritis, although 50 per cent continued to experience occasional cystitis. Surgical correction of reflux had no beneficial effect on renal size, renal scars or significant proteinuria with impaired renal function. Antireflux surgery does not appear to be justified in cases of proteinuria unless recurrent symptomatic pyelonephritis becomes uncontrollable. Additionally, antireflux surgery did not appear to have any beneficial effect on hypertension or large bladder capacity. However, calculogenesis remained inactive with this and other adjunctive therapies.