Schröder A
Klinik und Poliklinik für Urologie und Kinderurologie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstraße 1, 55131, Mainz, Deutschland.
Urologe A. 2017 Sep;56(9):1158-1163. doi: 10.1007/s00120-017-0453-x.
Primary vesicoureteral reflux (VUR) is a dynamic disease with several factors influencing its course. Therapeutic options range from watchful waiting to open surgery. Multiple risk factors for the development of pyelonephritis are identified, which then determine the decision for the appropriate treatment option. They include age, gender, history of pyelonephritis and renal scarring, bladder and bowel dysfunction (BBD), circumcision status and parental preference. The use of continuous antibiotic prophylaxis (CAP) is becoming increasingly controversial with antibiotic resistance being a major concern. Aggressive treatment of BBD and infant circumcision can greatly reduce the risk for pyelonephritis and should always be considered and discussed. This article is soley concerned with primary VUR.
原发性膀胱输尿管反流（VUR）是一种受多种因素影响病程的动态疾病。治疗选择范围从密切观察等待到开放手术。已确定了肾盂肾炎发生的多种风险因素，这些因素随后决定了合适治疗方案的选择。它们包括年龄、性别、肾盂肾炎和肾瘢痕形成史、膀胱和肠道功能障碍（BBD）、包皮环切状态以及父母的偏好。由于抗生素耐药性成为主要问题，持续抗生素预防（CAP）的使用正变得越来越有争议。积极治疗BBD和对婴儿进行包皮环切可大大降低肾盂肾炎的风险，应始终予以考虑和讨论。本文仅关注原发性VUR。
