L P Connolly1, S T Treves, D Zurakowski, S B Bauer. 1. Department of Radiology (Division of Nuclear Medicine), Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Abstract
PURPOSE: We attempted to assess the natural course of vesicoureteral reflux after it was detected in asymptomatic siblings of children with reflux, and to determine predictors of and time to resolution. MATERIALS AND METHODS: We reviewed the records and radionuclide cystograms of 76 girls and 32 boys 2 weeks to 103 months old (mean age 21 months) with vesicoureteral reflux detected in a sibling screening program. Predictors were determined using logistic regression and survival analysis. RESULTS: Vesicoureteral reflux resolved in 52.8% of cases at a mean followup of 18.5 months. Yearly resolution rates exceeded 28%. Predictors of the likelihood of resolution were not identified. At diagnosis unilateral reflux and mild reflux were independent and univariate predictors, respectively, of more rapid resolution. CONCLUSIONS: By showing that spontaneous resolution is likely for children with vesicoureteral reflux detected in a sibling screening program, this study supports nonsurgical management with annual imaging evaluation.
PURPOSE: We attempted to assess the natural course of vesicoureteral reflux after it was detected in asymptomatic siblings of children with reflux, and to determine predictors of and time to resolution. MATERIALS AND METHODS: We reviewed the records and radionuclide cystograms of 76 girls and 32 boys 2 weeks to 103 months old (mean age 21 months) with vesicoureteral reflux detected in a sibling screening program. Predictors were determined using logistic regression and survival analysis. RESULTS: Vesicoureteral reflux resolved in 52.8% of cases at a mean followup of 18.5 months. Yearly resolution rates exceeded 28%. Predictors of the likelihood of resolution were not identified. At diagnosis unilateral reflux and mild reflux were independent and univariate predictors, respectively, of more rapid resolution. CONCLUSIONS: By showing that spontaneous resolution is likely for children with vesicoureteral reflux detected in a sibling screening program, this study supports nonsurgical management with annual imaging evaluation.
Authors: Jonathan C Routh; Frederick D Grant; Paul Kokorowski; Richard S Lee; Frederic H Fahey; S Ted Treves; Caleb P Nelson Journal: Pediatrics Date: 2010-10-18 Impact factor: 7.124