Nhungo Charles John, Mwakalukwa Kelvin Richard, Wambura Erasto Phares, Kibona Herry Godfrey, Mushi Fransia Arda, Msangi Nimwindael Stephen, Maro Isaack Mlatie, Kimu Njiku Marko, Nyongole Obadia Venance, Mkony Charles A
Department of Surgery, School of Medicine Muhimbili University of Health and Allied Sciences Dar es Salaam Tanzania.
Department of Urology Muhimbili National Hospital Dar es salaam Tanzania.
Clin Case Rep. 2024 Jul 4;12(7):e9132. doi: 10.1002/ccr3.9132. eCollection 2024 Jul.
Conservative nonsurgical therapy ensures that the resolution is nearly 80% for vesicoureteral reflux grades I and II and 30%-50% for vesicoureteral reflux grades III and V within 4-5 years of follow-up. Open surgical reimplantation of ureters of grades IV and V is a highly successful procedure, with reported correction rates ranging from 95% to 99% regardless of the severity of vesicoureteral reflux.
Patients with vesicoureteral reflux present with a wide range of severity. With an incidence of approximately 1%, vesicoureteral reflux is a relatively common urological abnormality in children. Postnatal diagnosis of vesicoureteral reflux is typically made following a diagnosis of a urinary tract infection and less frequently following family screening. Voiding cystourethrograms remain the gold standard for diagnosing vesicoureteral reflux. To preserve the kidney and prevent the need for potential renal replacement therapy, infants with a single kidney require significantly more assessments and prompt decision-making. Surgical correction is advised for patients with vesicoureteral reflux grades IV and V, while vesicoureteral reflux grades I, II, and III are managed conservatively.
保守非手术治疗可确保在4至5年的随访期内，I级和II级膀胱输尿管反流的治愈率接近80%，III级和V级膀胱输尿管反流的治愈率为30%至50%。IV级和V级输尿管的开放手术再植是一种非常成功的手术，无论膀胱输尿管反流的严重程度如何，报告的矫正率在95%至99%之间。
膀胱输尿管反流患者的严重程度差异很大。膀胱输尿管反流的发病率约为1%，是儿童相对常见的泌尿系统异常。膀胱输尿管反流的产后诊断通常在诊断尿路感染后进行，较少在家族筛查后进行。排尿性膀胱尿道造影仍然是诊断膀胱输尿管反流的金标准。为了保护肾脏并避免潜在的肾脏替代治疗需求，单肾婴儿需要更多的评估并迅速做出决策。对于IV级和V级膀胱输尿管反流患者建议进行手术矫正，而I级、II级和III级膀胱输尿管反流则采用保守治疗。
