Monitoring • statural growth • completeness of bladder emptying - may require double-voiding, Mx of constipation • kidney growth - serial ultrasound scans • breakthrough UTIs • progression (if any) of scars • renal function
Management • Secondary VUR – Rx primary cause. • Primary: watchful monitoring in - all infants regardless of grade - older children with grades I –III • Rationale – - most VUR resolves spontaneously - no significant difference in outcome between surgical and medical Mx
Surgical Intervention considered: • Recurrent pyelonephritis especially in high grade VUR
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