Initially, radiographic grading of VUR was the only method of measuring the severity of VUR and of calculating the chance of spontaneous resolution. However, several other factors such as age, sex, presence of bladder and/or bowel dysfunction, presence of associated anatomic abnormalities, and laterality have been shown to have an influence on the spontaneous resolution rate.
Based on the results of recent randomized studies (PRIVENT, Randomized Intervention for Children with Vesicoureteral Reflux [RIVUR], Swedish reflux study) and the updated VUR guidelines from the American Urological Association and the European Association of Urology-European Society for Pediatric Urology, this review will give an overview of the important clinical features of VUR, the diagnostic methods, the computer models and nomograms to detect which children with VUR should be treated, and the options their respective chances of success for treating patients. It will become clear that the treatment selection and decision for treating VUR in a child is an individualized process.