Vesicoureteral reflux in the adult. IV. Medical versus surgical management.

A group of 27 adults with bilateral primary vesicoureteral reflux diagnosed during a 10-year interval was managed medically for a mean of 87 months. Their outcome was compared to that of 67 adults with bilateral primary reflux treated surgically during the same interval. In both groups the presence of renal insufficiency and hypertension correlated with the severity of renal scarring. Furthermore, the fate of renal function was similar irrespective of the method of management and appeared to be determined by the severity of renal scarring, level of renal function at initial evaluation and presence of proteinuria. The 2 groups appeared to fare equally well during the followup of up to 13 years.