Treatment :- Primary reflux depends on the severity, the time of diagnosis(age), and kidney function at the time of diagnosis. Certain basic principals are followed in therapy: one is that reflux by itself is not harmful or dangerous, but, together with infection can cause severe renal damage; secondly, reflux that is picked up early will have caused les damage than one picked up later - this is because reflux has been present since birth; and thirdly, reflux is known to decrease in grade and even disappear with increasing age of the child, so if we wait for an adequate time without allowing infection to occur, there may be no reflux after a few years later. The last and most important principal is to prevent infection and reflux may take care of itself. Thus the therapy for grade 1 - 3 reflux in children with adequate renal function is prevention of infection: this is done by giving a long term, low dose antibiotics to the child for a period of 3 - 4 years under proper supervision and regular check ups The indications for change in therapy in these children are - urinary infections despite regular antibiotics, if grade of reflux is 4 - 5, if kidney function is severely affected to start with. The only alternate therapy in these cases is surgical correction of the reflux. Surgery for reflux is called a reimplantation of the ureter into the bladder. This is a very major surgery where the ureter is disconnected from the original position, and a fresh tunnel is made within the bladder and the ureter is taken thru this and sutured to the bladder at a different position. The new tunnel must be at least 3 - 4 times the diameter of the ureter to avoid a reflux post operatively. Tubes are kept to drain the urine from the kidneys directly in the ureter. These tubes may be removed after 10 days. The child stays in the hospital for 10 - 12 days before being sent home after removal of all sutures.