Abstract：
Long-term adult outcomes of children diagnosed with urinary tract dilatation (UTD) and vesicoureteral reflux (VUR) are not clearly documented in the literature. Likewise, follow-up protocols for these patients as they transition through adolescence and into adulthood vary with institution and cultures. Several studies have shown that individuals diagnosed with VUR in childhood are at higher risk of urinary tract infection (UTI) throughout their lives, even in the setting of prior VUR resolution or surgical correction. This is particularly relevant in patients with renal scarring, who are at higher risk of UTIs, hypertension and renal function deterioration in pregnancy. The risk of adverse maternal and fetal outcomes in pregnancy are higher for women with significant chronic kidney disease (CKD). Patients who underwent endoscopic injection or reimplantation should be counselled on the long-term particular risks associated with each intervention, including calcification of ureteric injection mounds, and the potential challenges of future endoscopic procedures following reimplantation. Although there is no evidence for the direct correlation between conservatively managed UTD in childhood, and symptomatic UTD diagnosed in adulthood, all patients should be aware of the long-term risks of persistent upper tract dilatation. Lastly, bladder-bowel dysfunction (BBD) management in adolescence can be more challenging and may contribute to symptomatic recurrence in this age group.
摘要：
文献中没有明确记录诊断为尿路扩张（UTD）和膀胱输尿管反流（VUR）的儿童的长期成人结局。同样，这些患者从青春期过渡到成年期的随访方案因机构和文化而异.一些研究表明，儿童时期被诊断为VUR的个体一生中尿路感染（UTI）的风险更高，即使在设置之前的VUR分辨率或手术矫正。这在肾瘢痕形成的患者中尤其重要，谁是尿路感染的高风险，妊娠期高血压和肾功能恶化。对于患有严重慢性肾脏疾病（CKD）的女性，怀孕期间不良母婴结局的风险更高。接受内窥镜注射或再植入的患者应就每次干预相关的长期特殊风险进行咨询。包括输尿管注射桩的钙化，以及再植入后未来内窥镜手术的潜在挑战。虽然没有证据表明儿童期保守管理的UTD之间存在直接相关性，以及在成年期诊断出的有症状的UTD，所有患者都应该意识到持续上尿路扩张的长期风险.最后,青春期膀胱肠功能障碍(BBD)的治疗更具挑战性,并可能导致该年龄组的症状性复发.
