Vesicoureteric reflux and videourodynamic studies: results of a prospective study after three years of follow-up.

OBJECTIVE To study prospectively the influence of videourodynamic studies on the management of children with vesicoureteric reflux. METHODS One hundred one children with reflux were investigated routinely with videourodynamic studies, as well as renal scans, ultrasound studies, and/or intravenous urograms. The studies were repeated at one, three, and five years. If bladder instability was demonstrated, the primary treatment consisted of anticholinergic drugs and antibiotics, regardless of the grade of reflux. In reflux Grades IV and V with instability and renal scars, surgery was performed. In case of a stable bladder, reflux Grades I-III received antibacterial treatment, while surgical correction was used for reflux Grades IV and V. RESULTS The results of three years of follow-up of 101 children are reported. Bladder instability was found in 39 children. Thirty of them with reflux Grades I-IV and instability could be managed with anticholinergic and antibacterial drugs, while 9 needed surgical correction. CONCLUSIONS A voiding cystourethrogram is only sufficient for the detection of reflux but for correct management of these children a (video)urodynamic study is mandatory. After treatment of frequently found bladder dysfunction, the reflux will disappear in the majority of cases.