You have mentioned 35 years old daughter, its not clear. There are various causes of VUR, so need to know the cause first. You have mentioned 48/52% kidney function which is also not clear. Is the renal function in blood parameters normal? (serum creatinine, urea) The long term antibiotics prophylaxis is necessary to prevent infection of urinary tract. The decision to do surgery or not depends upon the grade of VUR, the cause of VUR, blood level of urea, creatinine and so on. So we should need to look as a whole. You can have online consultation with pediatric surgeon gere via hamrodoctor to get opinion with reports. Please go through this link: https://www.hamrodoctor.com/service/pediatrics