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Is surgical method better and necessary for vesicoureteric reflux ?

my daughter is suffering from primary VUR Gr3/Gr2 left&right withnormal DMSA report,without hydronephrosis& renal dysplasia .she had one febrile UTI at the age of three in2007.she was on ABP (uritop1/3 dose)recently she had one breakthrough UTI managed medically.Now the doc is telling it is persisting one you have to undergo a surgery called ureteral re-implantationand mentioning that she may not have any problem now but in future during her pregnancy in the form of HTN&ESRD.but my search in medical databases which includes meta analysis,sys reviews&RCT s are showing no significant difference between medical&surgical management.moreover prenancy related problems are only due to congenital renal dysplasia not due to VUR.MY queries are; surgical management necessary?is there any evidence for it s superiority? 2.can we wait till puberty for self correction? --3.can medical management be an option? there any study evidence the primary VUR led to pregnancy problems? 5.what are the latest articles in this regard?
Asked On : Sat, 16 Apr 2011
Answers:  3 Views:  103
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Pediatrician 's  Response
welcom to HCM.
VUR with grad 1 to3 there are not need to be any surgical management. it can be cure by taking oral such case she has to take medicine for 4to6 month, then she will be cure. so not go for surgerr ,start oral medicinefor that period, you should discuss it with your treating doc also.
DR aseem 9982583020
Answered: Tue, 21 Jun 2011
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Urologist Dr. Mukassar Mohiuddin's  Response
1. Grade 2 & 3 reflux are managed conservatively...I mean by medical management.
2. Yeah, U can surely wait for self correction, if your child doesnt get too many UTIs very frequently.
3. Yeah, medical is definitely an option.
4. Pregnancy usually causes some obstruction to the ureters...
5. Articles are usually found in journals...u can search for journals related to Urology on the internet
Answered: Tue, 21 Jun 2011
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Urologist Dr. Rajiv goel's  Response
Welcome to healthcaremagic,
you need to find out what is the grade of reflux at present. You can continue on conservative management as DMSA and USG are normal. However, if reflux persists then you should get it operated before puberty. if reflux persists in pregancy chances of having severe pyelonephritis are very high and ideally it should be corrected
Answered: Wed, 22 Jun 2011
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