[Long-term results of primary vesico-ureteral reflux from the distal ureter treated medically and surgically in children].

The authors study fifty five cases of reflux, involving ninety five reno-ureteral units, with a followup of then to eighteen years. The renal injuries were invariably secondary to an infection. The fate of pyelonephritic kidneys was dramatic--out of a total of fifteen, only five showed normal growth, and the other ten showed a standard deviation of at least - 4; surgery does not prevent an adverse evolution. The lesions may appear postoperatively during the period of medical treatment (4 out of 70 in this series). Non-infected refluxes are not harmful, because of the possibility of compensating hypertrophy. Unsuccessful surgery does not compromise the fate of the kidney, because of early reoperation. The main factor in the prognosis is effective treatment as soon as the symptoms appear.