Vesicoureteral reflux in patients with posterior urethral valves.

PURPOSE

We reviewed our experience with posterior urethral valves to analyze the influence of reflux.

MATERIALS AND METHODS

We retrospectively analyzed the records of 73 consecutive patients with posterior urethral valves. Of the patients 35 boys had reflux at presentation, which was unilateral in 18 (severe in 17) and bilateral in 17 patients (severe unilateral reflux and low grade contralateral reflux to a better functioning kidney in 5). Followup ranged from 1 to 17 years (mean 5.6).

RESULTS

Reflux resolved after relief of obstruction in 11 of 44 (25%) evaluated renal units but only 5 of 35 (14%) units with high grade reflux. The reflux more often resolved in the bilateral than unilateral group (35% of units versus 11%) and usually did so on the initial study after obstruction relief. Neither the presence, grade, pattern of reflux nor type of initial treatment impacted the outcome in terms of overall renal function. The function of the involved kidney did affect the likelihood of resolution in that unit. Resolution occurred in 10% of refluxing units that provided less than 20% function versus 39% in units with better function.

CONCLUSIONS

Vesicoureteral reflux is common with posterior urethral valves and often persists, particularly to a poorly functioning kidney. Resolution, if it occurs, usually does so early after relief of obstruction. Reflux, no matter what the pattern, has not been a significant prognostic factor for renal function in this series.