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Straub, J.; Apfelbeck, M.; Karl, A.; Khoder, W.; Lellig, K.; Tritschler, S.; Stief, C.; Riccabona, M. (2016): Vesikoureteraler Reflux. Diagnose und Therapieempfehlungen. In: Urologe, Vol. 55, No. 1: pp. 27-34
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Vesico-ureteral reflux (VUR) is one of the most common urologic diseases in childhood. About every third child that presents with a urinary tract infection (UTI) has urinary reflux to the ureter or kidney. Demonstration of a backflow of urine into the ureters or kidneys proves vesicoureteral reflux. In unclear cases, a positioned instillation of contrast agent (PIC) cystogram might be performed and is able to prove vesico-ureteral reflux. Since low-grade VUR has a high probability of maturation and self-limitation, infants with VUR should be given prophylactic antibiotics during their first year of life, reevaluating the status of VUR after 12 months. The aim of any treatment is to prevent renal damage. The individual risk of renal scarring is decisive for the choice of adequate therapy. This risk is mainly dependent on reflux grade, age, and gender of the child as well as parental therapy adherence. In principle, therapeutic options include conservative as well as endoscopic or open surgical antireflux therapies. Decisions on treatment should be made individually with parents taking into account all the findings available.