1- radiological information:
Ultrasound: Systematic dice the first episode of UTI (boy or not)
CUM (retrograde cystography): Episode 2 in girls; from the 1st episode in boys
IVU: in case of anomalies on ultrasound, the MUC
Before any abnormality of the urinary tract systematically search for VUR by CUM
2- vesicoureteral reflux:
Most common in infants and young children under 5 years
RVU is frequently associated with acute pyelonephritis
Prophylaxis (after UTI) 6 months -> cyto-bacteriological examination urine each month and then every 3 months as appropriate. CUM every 12 months
Grade I, II, III: continuing the prophylactic treatment for several years; frequent disappearance of reflux
Grade IV, V: Surgical treatment for discussion after 1 year of medical treatment
Prophylactic treatment should be continued for 1 year after the disappearance of reflux
3- Classification:
Grade I: interesting reflux ureter
Grade II: reflux uretero-renal pelvis dilatation without calyceal
Grade III: minimal to moderate dilatation of the ureter and / or tortuous ureter with moderate dilatation of the pelvis;Light erase chalices
Grade IV: moderate dilatation of the renal pelvis and chalices.
Grade V: huge expansion and deformation of the ureter; expansion chalices ++
4- formal surgical indications:
VUR with recurrent pyelonephritis uncontrollable
VUR grade V persisting after the age of 1 year
Grade IV VUR in children over 2 years
Prophylaxis: 6 months or more if high IU or presence of a malformation uropathy.
More than 50% of children have recurrent
