Spontaneous remission of established quartan malarial nephrotic syndrome is very rare. Renal failure is progressive and leads to end-stage disease in about 3 to 5 yr. Antimalarial or corticosteroid therapy induces a remission or slows progression of renal failure only in patients with mild glomerulopathy. Schistosomiasis causes urinary lesions involving the bladder, lower ureters, and seminal vesicles and frequently the vas deferens, prostate, vagina, and adnexa. Symptoms are frequent micturition and, occasionally, dysuria.
Diagnosis is made by finding the ova in urine.
At this stage, the urinary abnormalities are completely reversible with treatment. Chronic sequelae present as renal and urinary tract syndromes. Ureteral obstruction is the most common urologic problem and, when severe, is associated with obstructive nephropathy. Most urinary symptoms, however, are caused by ulcerative and fibrosing bladder lesions and carcinoma. A common complication, transient VUR, may occur during active disease and with moderate to severe secondary bacterial infection.