[Primary vesicoureteral reflux in childhood : Diagnostics, risk stratification and treatment].

Primary vesicoureteral reflux (VUR) is a common urological condition in childhood. It is caused by a congenital valve mechanism insufficiency resulting from a shortened submucosal ureter. This leads to retrograde urine flow into the ureter and kidneys and increases the risk of recurrent febrile urinary tract infections (UTI) and renal parenchymal scarring. The International Reflux Study Group classifies VUR into five degrees of severity. The diagnostics focus on basic diagnostics and instrumental reflux testing after risk stratification. A risk-adapted conservative strategy has become the standard treatment as low degrees of reflux often resolve spontaneously. The aim of VUR treatment is to prevent renal scarring and renal dysfunction. Antibacterial prophylaxis may be indicated in selected children. In cases of severe or treatment-resistant symptomatic VUR, endoscopic, laparoscopic/robotic-assisted or open surgical procedures with the corresponding indications should be discussed.