What is the common management approach for children with grades I and II vesicoureteral reflux?

For children diagnosed with grades I and II vesicoureteral reflux, the common management approach is to medically manage the condition due to the high likelihood of spontaneous resolution. In these lower grades of reflux, the condition is often mild and has a favorable prognosis. Studies have shown that many children with grades I and II reflux can experience complete resolution of the reflux as they grow older, often without the need for invasive interventions.

Management typically involves monitoring and may include prophylactic antibiotics to prevent urinary tract infections, especially in infants and young children, but it does not necessitate immediate surgical intervention. These children are closely followed to ensure that there are no complications or infections that could indicate a more serious issue, but since spontaneous resolution is common in these cases, aggressive treatment is generally not required.

In contrast, immediate surgical intervention is more commonly reserved for higher grades of reflux or in cases where there are significant complications, and a high-sodium diet is not indicated for managing vesicoureteral reflux. Additionally, managing only if symptoms worsen may not be the best strategy, as ongoing monitoring and preventive measures can be beneficial even in asymptomatic cases. Thus, conservative medical management is the preferred approach for grades I and II reflux.