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Revista Cubana de Pediatría

versión impresa ISSN 0034-7531versión On-line ISSN 1561-3119


DURAN ALVAREZ, Sandalio. Reflujo vesicoureteral: conceptos actuales. Rev Cubana Pediatr [online]. 2000, vol.72, n.2, pp.132-143. ISSN 0034-7531.

A literature review was made from which the following conclusions were drawn: Renal scars may occur without vesico-ureteral reflux and may not be present when there is severe reflux. Although infants are at more risk, older children are also vulnerable. Surgical repair of vesico-ureteral reflux does not reduce incidence of recurrent urinary infection, so surgery is not a treatment of choice but probably an exceptional measure. Vesico-ureteral reflux tends to disappear spontaneously. No antibiotics should be prescribed in children with asymptomatic bacteriuria since they are potentially dangerous. The presence or not of vesico-ureteral reflux should be determined by urethocystography in every patient under 5 years of age suffering from febrile acute urinary infections and specially in children under 3 years, regardless of sex and the result of ultrasound study, and also in children of any age if ultrasound test detects scars, pelvic dilation, wrong corticomedullary delimitation or dysplasia signs; it should also be studied in prenatal hydronephrosis confirmed after birth and in children with unilateral renal agenesis or multicystic renal dysplasia. Siblings and children of patients with vesico-ureteral reflux need to be specially assessed. It has not been proved so far that antimicrobial prophylaxis can prevent renal damage in patients with vesico-ureteral reflux. Controlled studies are required to be able to accurately define the usefulness or ineffectiveness of antibiotics. It is recommended not to use it in children over 3 years of age.


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