Objective: To determine the long-term outcome of patients operated for primary vesicorenal reflux (VRR) in childhood.
Materials and method: This study concerned 88 patients successfully operated for VRR in childhood before 1986 and who answered a questionnaire in 2001. The medical files were reviewed retrospectively and reflux was re-evaluated according to the latest international classification.
Results: The median follow-up was 21.5 years [range: 15-27]. The mean age at the time of diagnosis was 5.5 years. In 92% of cases, reflux presented in the form of acute pyelonephritis (APN). 88.5% of the patients contacted declared that they were in good general health and 15.4% of males and 50.6% of females presented episodes of cystitis. However, only 16% of females and no males reported episodes of APN. The presence of renal lesions did not statistically increase the risk of febrile urinary tract infection. No case of APN occurred during the 37 pregnancies reported. One female patient suffered from renal failure due to an aetiology unrelated to reflux. One female patient with a scarred kidney before the operation presented hypertension.
Conclusion: This study shows that the outcome of patients operated for primary VRR in childhood is favourable despite the persistence of APN. The increasingly early surgical management of VRR will certainly be optimized by long-term follow-up studies with initial assessment of the lesions based on scintigraphic techniques.