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Dr. Andrew Rynne

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Is surgical management necessary for curing primary VUR?

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 pregnancyin 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; 1.is 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? 4.is there any study evidence the primary VUR led to pregnancy problems? 5.what are the latest articles in this regard?
Fri, 28 Sep 2018
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General Surgeon 's  Response
Hi,

Kindly find the answers as per the query in details below.
1. The surgical management is necessary for a permanent cure. You can review the operated patient series data from the urology surgeon set up.
2. There are no chances of self-correction by puberty anyhow.
3. Medical management is going to give symptomatic relief or curing recurrent infections, not the underlying VUR.
4. There are no study pieces of evidence of pregnancy issues.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Bhagyesh V. Patel,
General Surgeon
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