Understanding Vesicoureteral Reflux in Children

Understanding vesicoureteral reflux in children

https://commons.wikimedia.org/wiki/ File:Vesicoureteral-reflux-004.jpg

Vesicoureteral reflux in children is a condition that must be carefully monitored. This condition occurs when the valve where the ureter and bladder meets does not work correctly.

What is Vesicoureteral Reflux?

Normally when urine collects in the bladder, the valve prevents the urine from flowing back into the ureters and up towards the kidney. If this process does not happen correctly an infection results. If this back-flow occurs, the condition is known as reflux. 

Urine flowing back into the kidneys is dangerous and can also result in a kidney infection which can lead to damage in the kidneys and potentially cause the onset of hypertension.

What if Your Child is Diagnosed with Vesicoureteral Reflux?

If a child has persistent problems with urinary tract infections his/her pediatrician will recommend a voiding cystourethrogram (VCUG) diagnostic test. This test entails putting a plastic tube into the child’s uretha and injecting contrast fluid into the bladder in order to examine for the presence of reflux.

If reflux is detected, further diagnostic tests may be ordered in order to check the health of the kidneys.

Understanding Vesicoureteral Reflux in Children

With reflux, treatment may vary depending on the severity of the condition and the child’s age, the younger the child the higher chance of resolution on its own. There are different grades of this condition and are typically ranked from 1 to 5. One being the mildest form of vesicoureteral reflux and 5 being the most severe.  

How the reflux is managed will depend upon the grade diagnosed. In many instances the milder grades of 1 and 2 do not require any surgical intervention, however, a long-term preventative treatment of a low dose of antibiotics may be prescribed in order to prevent and combat the frequent urinary tract infections from occurring until the child outgrows the condition. If a child becomes desensitized to one antibiotic, other kinds of antibiotics are likely to be prescribed.

In addition, regular testing will be done to monitor the condition until it goes away. In grades 1 and 2 reflux, approximately 85 percent of the cases resolved on its own as the child grows. Grade 3 reflux may also resolve on its own, but its percentage is not as high as it is for grades 1 and 2.

Grades 4 and 5 reflux typically do not resolve on its own. These grades of vesicoureteral reflux almost always require surgery to correct the condition. The procedure entails creating a “flap-valve apparatus for the ureter that will prevent reverse flow of urine into the kidney. In more severe cases, the scarred kidney and ureter may need to be surgically removed” (University of Rochester Medical Center).

Reflux surgery is usually highly successful and the child will no longer suffer through urinary tract and/or kidney infections. However, new treatments are being introduced and any child who has any form of reflux should always be monitored by a physician.

 

Additional sources:

https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=90&ContentID=P03119
Information given to me by physicians and from discussions with physicians

Photo credit: https://commons.wikimedia.org/wiki/File:Vesicoureteral-reflux-004.jpg


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