• 1048, Behind Badi Masjid Rahmania, Ramganj Bazar Jaipur, Rajasthan 302003 India
  • +91-94149 85117
  • dr.aadil.urokids@gmail.com

Vesicoureteric Reflux (VUR)

img

What is vesicoureteral reflux (VUR)?

The kidneys produce urine, which travels down tubes called the ureters. The ureters empty into the bladder where urine is stored. During urination, the bladder contracts & urethral sphincter relaxes.

Vesicoureteral reflux (VUR) occurs when urine in the bladder flows back into one or both ureters and often back into the kidneys. This may occur because of the position of the ureter in the bladder wall.

VUR is graded according to severity from grade 1 (mild) to grade 5 (severe).

The level of severity is determined by urine flow and the extent of the associated dilation.

Testing and diagnosis

Voiding cystourethrogram (VCUG) is used to confirm the diagnosis of VUR. The VCUG takes 15 to 20 minutes.

Signs and symptoms

  • Urinary tract infection (UTI) associated with a fever.
  • Ante-Natal USG scan; Due to the increased use of prenatal ultrasounds, hydronephrosis (dilation of the kidneys) can be detected before birth.
  • About 1 percent of healthy children have reflux; many will never have an infection or need treatment.
img
img

Risks

VUR does not cause a urinary tract infection. VUR allows bacteria that may be in the bladder to travel with the refluxing urine to the kidney. This can then cause a kidney infection or pyelonephritis. This may lead to “scarring“ of kidneys and loss of function, CKD.

Treatment

Lower grades of reflux will often resolve on their own, typically at 5 to 6 years of age. The goal is to prevent UTIs and kidney damage while the reflux is improving.

  • Antibiotic prophylaxis: It has been the gold standard of care.
  • Bathroom habits and fluid intake: If your child is toilet-trained, her bathroom habits are very important. We encourage your child to empty her bladder every two to three hours, without holding. We assess for any signs of constipation which can contribute to the occurrence of a UTI. We also ask your child to increase the amount of water she drinks. All of these steps can help reduce the risk of bacteria growing in your child’s urine.
  • Surgical intervention: Children who have grade 4 and 5 reflux or who have had repeated UTIs with concerns of kidney scarring, may require surgical intervention to fix the reflux.
img
img

Surgical options

Many factors should be considered when deciding about what treatment is best for your child: the severity of the reflux, whether the reflux is in one or both ureters, your child’s age and gender and the presence of kidney damage. We will thoroughly discuss all options with you and your child.

  • Endoscopic surgery Through Cystoscopy an injection of Dextranomer is given at ureteric orifice. This prevents ureteric reflux.
  • Ureteral reimplant: Under general anesthesia and through a lower abdominal incision, the ureter is reimplanted where it joins the bladder. Ureteral reimplantation corrects the anatomical abnormality that allows urine to flow back into the ureter.

Client Opinions & Reviews