The management of vesicoureteric reflux in children.

One hundred and seventy children with vesicoureteric reflux have been reviewed. Conservative therapy was the treatment of choice in Grade I reflux. Children with Grade II and Grade II reflux treated conservatively developed progressive upper tract dilation and scarring. Unilateral reflux sometimes became bilateral. In addition, the grade of reflux could worsen in the absence of symptoms or overt infection. Cystourethroscopy was an important investigation as an aid to management: the findings of abnormal ureteric orifices in the presence of Grade II and Grade III reflux indicated early surgical treatment. Surgery was also indicated in the presence of ureteric dilatation on excretion urography aand/or micturating cystourography. Vesicouretic reimplantation gave excellent results with few complications.