Vesicoureteral Reflux
Vesicoureteral reflux (VUR) is characterized by the retrograde flow of urine from the bladder to the kidneys. the bladder contracts and urine leaves the body through the urethra. With vesicoureteral reflux, some urine goes back up into the ureters and possibly up to the kidneys. Reflux exposes the kidneys to infection. In children, particularly those in the first 6 years of life, urinary infection can cause kidney damage. The injury to the kidney may result in renal scarring and loss of future growth potential or widespread scarring and atrophy. Even a small area of scarring in one kidney may be a cause of high blood pressure later in life.There are two types of Vesicoureteral reflux. Primary VUR occurs when a child is born with an impaired valve where the ureter joins the bladder. This happens if the ureter did not grow long enough during the child's development in the womb. The valve does not close properly, so urine backs up (refluxes) from the bladder to the ureters, and eventually to the kidneys. This type of Vesicoureteral reflux can get better or disappear as the child gets older.The ureter gets longer as the child grows, and the function of the valve improves.
Secondary Vesicoureteral reflux occurs when there is a blockage anywhere in the urinary system. The blockage may be caused by an infection in the bladder that leads to swelling of the ureter. This also causes a reflux of urine to the kidneys. Vesicoureteral reflux occurs first is In some children the tunnel of the lower ureter through the muscular wall of the bladder may not be long enough. For these children, there is a good chance that growth may provide the necessary difference to allow the valve to work second is ureter may enter into the bladder abnormally (usually too much to the side), resulting in a short tunnel. This reflux is less likely to resolve with growth. Some children have reflux because of underlying problems such as lower urinary obstruction.
Causes of Vesicoureteral Reflux
Common causes of Vesicoureteral Reflux
- Intravesical ureter.
- Siblings have the irregularity.
- Neural tube defects.
- Urinary tract.
- Abnormalities.
- Caucasian.
- Hydronephrosis.
Symptoms of Vesicoureteral Reflux
Common symptoms of Vesicoureteral Reflux
- Bedwetting ( nocturnal enuresis )
- Collection of urine in the renal pelvis (hydronephrosis)
- Distention in the abdomen.
- Failure to thrive
- High blood pressure ( hypertension ; caused by kidney damage)
- Nausea.
- Vomiting
- Protein in the urine.
- Urgency
- Dribbling
- Wetting pants.
- Poor weight gain.
Treatment of Vesicoureteral Reflux
Common Treatment of Vesicoureteral Reflux
- Sometimes surgery is done to correct the reflux. Sometimes children are treated with long-term antibiotics to prevent infections while waiting for them to outgrow the reflux.
- Evidenced-based guidelines to help determine the best treatment options depending on the age of the child and the nature of the reflux.
- Reflux involves either long-term antibiotics to prevent urinary tract infections or surgery to correct.
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