[guest]

I have a question regarding surgical repair for Reflux as I cannot find difinitive answers as to whether surgery is the way to go for bilateral grade 2 & 3 reflux with no recurrent UTIs and no scarring. Child was originally diagnosed as bilateral grade 3 & 4 at 3 months of age. Put on AB regimen and followed by urologist At age 5 AB regimen was stopped by parents for fear of long term effects. At that time RNC showed improvement (grade 2 & 3). Parents decide to continue to monitor. Child is now 10 yo and has had no UTI's Ready to schedule "final" RNC to determine whether surgical repair is necessary as parents have been told that it is highly unlikely for resolution after age 10. If child is still grade 2 &3 or better do we still have it surgically repaired? Urologist at last visit said it should be repaired if ANY reflux is shown??? Parents prefer not to have surgery but do not want child to have any long term effects.

[UroDoc]

In general grade 3 and less have the best chance of improving with age. Another option instead of the formal open surgery would be to consider injectables at the ureteral orifice. They may want to ask their pediatric urologist (a assume it is a true pediatric urologist as opposed to a pediatric surgeon with some urology training) about that option or go for a second opinion at a center that offers that type of treatment.

[guest]

Thank you for your reply. Urologist is Chief of Pediatric Urology and feels that surgery would provide the highest success rate. Parents however feel that surgery is being encouraged with no data to substantiate that it is the best thing or the right thing to do in a situation where the grade is 3 or less. Knowing how vital kidneys are, parents just want to be sure that whatever they chose to do it is in the best interest of the child especially in the long term.

[UroDoc]

Wait for the final VCUG results and then decide. As a parent I think I would have trouble going ahead with surgery with a grade 1 or 2, and would look for a more minimally invasive solution. Also if it turns out that low maybe the patient won't be the average one and it still may correct (small %) with more time. Good luck.

[guest]

Thank you again for your reply. My gut has told me to hold on for 10 years even though I've been pressured with each visit to the Urologist to go ahead w/ the surgery. I just want to be sure that I am not putting her kidneys at risk while playing the waiting game. I've always believed that there is something about a mother's gut instinct. Time will tell.