Fetal ureteric reflux: a follow-up study.

The findings in 21 children (17 males) with ureteric reflux diagnosed in the first 3 months of life and likely to have been present antenatally are described; 19 were followed up for between 2 and 8 years. Reflux was grade 3 and bilateral in 13 babies. Radioisotope studies showed evidence of renal parenchymal abnormalities in 45% of non-infected refluxing kidneys. Nonoperative treatment was adopted initially. The reflux disappeared completely in 6 children: evidence that it would do so was apparent within 2 years. Two children developed pelviureteric junction obstruction that was secondary to the dilatation accompanying the reflux. Anti-reflux surgery was performed in 10 children because the degree of reflux and upper urinary tract dilatation were increasing. Operative treatment for fetal ureteric reflux of advanced grades should be considered if there is no improvement after 2 years; gigantic reflux may otherwise ensue.