Vesicoureteral reflux in infants: what do we know about the gender prevalence by age?

N. Capozza, C. Gulia, Z. Heidari Bateni, A. Zangari, S. Gigli, V. Briganti, S. Tursini, C.J. Koh, M. Gaffi, S. Baldassarra, F. Signore, A. Porrello, R. Piergentili

Urologic Surgery Unit, Pediatric Hospital “Bambino Gesù”, Rome, Italy. aporrelloresearch@yahoo.com

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• Urology

OBJECTIVE: Vesicoureteral reflux (VUR) affects up to 1% of Caucasian children. Primary VUR is characterized by failure of the ureterovesicular junction to prevent urine from traveling in a retrograde fashion from the bladder to the ureters and the kidneys. Several reports in the literature describe the prevalence of this condition in pediatric patients; overall, VUR affects more males during infancy and with higher grades. However, a thorough consideration of these articles reveals important contradictions regarding the prevalence by gender and age. We analyzed those contradictions and suggested a possible explanation based on our single center experience with this patient group. In particular, for the age interval 0-2 years: we have found that (1) VUR mostly affects boys; (2) the male/female ratio steadily declines over time; (3) the unequal prevalence between males and females essentially disappears when children reach the age of two years.

CONCLUSIONS: The natural history of VUR in infant boys differs from that of infant girls, and therefore requires a gender-specific approach. Available data support the need to redefine the categorization and clinical guidelines for this disease.

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