Vesicoureteral Reflux Current Care Trends and Future Possibilities

VUR is a complex condition ranging from a benign self-resolving radiographic finding to a severe dis-ease associated with recurrent serious bacterial infection and chronic kidney disease. Investigation over the past 2 decades have improved our under-standing of the natural history of VUR and helped identify those at higher risk of both VUR itself as well as its potential severe sequelae including recurrent pyelonephritis and acquired renal injury. Although CAP has been demonstrated to be effec-tive in reducing the risk of recurrent UTI in children with VUR, efforts continue to identify those chil-dren most likely to benefit from CAP and to mini-mize adverse consequences such as resistant infection; the role of CAP in preventing renal scar-ring remains in question. New advanced analytic tools including artificial intelligence and machine learning have the potential to distill large volumes of granular data into practical tools that clinicians can use to guide diagnosis and management deci-sions for their patients and to identify specific pa-tient most likely to benefit from diagnosis. Surgical treatment, when indicated, remains highly effec-tive and is associated with low morbidity. Urolo-gists nonetheless continue to refine techniques to become less invasive and better tolerated.