The Natural History of Reflux – A Review

Abstract

Vesico-ureteric reflux should always be considered as an abnormality but often as a minor one with no serious consequences and with a good chance of spontaneous cessation. Ureteric dilatation as a result of reflux is seldom observed to be progressive when the bladder is normal and when the urine is sterile. The cause of the reflux is presumed to be some change taking place in foetal or early infant life. Obstructive renal damage to the kidney without infection must be very uncommon and of slow progress. Reflux does, however, predispose to infection and facilitates its ascent to the kidney. Chronic pyelonephritis in children is almost exclusively as the result of infection plus reflux and any child who has reflux is continually at risk of developing renal scars following a urinary infection. The indications for operation are discussed.