[Course of primary nonoperated vesicorenal reflux in children. Apropos of 44 cases].

From a series of 600 cases of reflux seen over 12 years, the authors chose a group of 44 children aged between 3 and 11 who had not been operated for their reflux. The period of follow-up ranged from 1 to 10 years. Treatment consisted of massive antibiotic therapy for the severe episodes of infection and maintenance treatments for more than six months in a great many cases. For this group of 44 children with 60 refluxing ureters, the results were: --a disappearance of infection in 82% of cases, --a disappearance of the reflux in 70% of cases, even including type III reflux. 4 children were lost to follow-up, and 5 had to be operated secondarily. The authors reserve this trial of medical treatment to reflux in the small child, intermittent reflux, reflux with no or only minor involvement of the upper urinary tract on I.V.P. and finally, reflux which causes infections particularly sensitive to medical treatment in the presence of a cooperative family. With the aim of reducing the irradiation to a minimum, the authors performed follow-up urography with a single 15 min film every two years and annual isotope cystography. The authors discuss the possibilities of extending this medical approach for the future.