1 REVIEW ARTICLE 방광요관역 류 치료 의 변천 과 이슈 The Changes and Issues in Treatment of Vesicoureteral

Studies for ＞50 years have suggested a link between recurrent urinary tract infection (UTI), vesicoureteral reflux (VUR) and renal parenchymal scarring. Common clinical practice has been that all children who present with a urinary tract infection must be evaluated for VUR. Long-term an-tibiotic prophylaxis administration, surgical correction of VUR, or both have been used to prevent UTI- and VUR-related renal scarring. In re-cent years, the effectiveness of continuous antibiotics prophylaxis in chil-dren with VUR has been intensely discussed. The question is not only whether antibiotics are effective but also they modify the natural history of disease and help to prevent the appearance of new scars. The recent randomized, controlled trials conclude that antibiotic prophylaxis confers little benefit for most children with VUR (grade I-IV). The endoscopic in-jection using dextranomer hyaluronic acid copolymer has been gaining popularity as an alternative to open surgery and chronic antibiotic prophylaxis. There remains concern regarding injection therapy, becaus