Which vesicoureteral reflux grade is least likely to resolve spontaneously?

Which vesicoureteral reflux grade is least likely to resolve spontaneously?

• A. Grade I
• B. Grade II
• C. Grade V
• D. Grade III

Answer: (C)

Spontaneous improvement of vesicoureteral reflux becomes unlikely as the reflux grade gets higher. In the most severe form, there is marked dilation and tortuosity of the ureter and renal pelvis with calyceal blunting, which reflects a fixed, significant abnormality of the vesicoureteral junction. That kind of structural defect is not something that growth alone tends to correct, so the reflux tends to persist and carries a higher risk of kidney damage. By contrast, milder grades often resolve as the anti-reflux mechanism matures, so the high-grade reflux is the least likely to go away on its own.

Spontaneous improvement of vesicoureteral reflux becomes unlikely as the reflux grade gets higher. In the most severe form, there is marked dilation and tortuosity of the ureter and renal pelvis with calyceal blunting, which reflects a fixed, significant abnormality of the vesicoureteral junction. That kind of structural defect is not something that growth alone tends to correct, so the reflux tends to persist and carries a higher risk of kidney damage. By contrast, milder grades often resolve as the anti-reflux mechanism matures, so the high-grade reflux is the least likely to go away on its own.