Department of Urology, Yale University School of Medicine, New Haven, CT.
Emory University and Children's Healthcare of Atlanta, Atlanta, GA.
Semin Pediatr Surg. 2021 Aug;30(4):151086. doi: 10.1016/j.sempedsurg.2021.151086. Epub 2021 Jul 15.
Primary vesicoureteral reflux often spontaneously resolves in children. However, in select patients, untreated reflux can contribute to recurrent pyelonephritis leading to irreversible renal damage. Management is therefore based on a given child's likelihood of recurrent urinary tract infections and risk of subsequent renal parenchymal injury. Therapeutic options for urinary reflux are diverse, ranging from observation with or without continuous low-dose antibiotic prophylaxis to a variety of operative interventions.
原发性膀胱输尿管反流在儿童中常可自发缓解。然而,在某些特定患者中,未治疗的反流可导致反复肾盂肾炎,进而导致不可逆转的肾损伤。因此,治疗取决于患儿尿路感染的复发可能性及其随后肾实质损伤的风险。治疗反流的方法多种多样,包括观察伴或不伴持续低剂量抗生素预防,以及各种手术干预。