REFLUXO VESICOURETERAL EM CRIANÇAS: ARTIGO DE REVISÃO

Vesicoureteral reflux (VUR) is the abnormal retrograde flow of urine from the bladder into the upper urinary tract – ureters and kidneys. According to the extent of the abnormal flow through the urinary tract and the severity of the lesions in the renal collecting system (caused by the reflux), both assessed by voiding cystourethrogram, this pathology may be classified in 5 different grades (I to V).VUR can be suspected prenatally by ultrasound findings of fetal hydronephrosis. Postnatally, on the other hand, this condition is usually diagnosed either after an investigation in an infant presenting with recurrent urinary tract infections (UTIs) or during screening of infants with a positive family history for significant VUR. The majority of infant patients who suffer from VUR will be cured without any intervention as they grow old. However, some of them will experience recurrent UTIs, which may result in kidney scarring. In terms of how to treat children with VUR, it is far from being a consensus among the experts. Some advocate a prophylactic antibiotic therapy only, whereas others believe that a surgical procedure is usually necessary. Our goal is to review the main aspects related to classification, clinical features, diagnosis, complications and treatment of children population affected with VUR.