Vesicoureteral Reflux
What is it?
Vesicoureteral reflux occurs when urine flows from
the bladder back into the ureters, and eventually into
the kidneys. A ureter is a tube that normally carries
urine from the kidney to the bladder, where it is held
until it is released from the body. Each kidney has a
ureter.
Who gets it?
Vesicoureteral reflux is usually seen in infants and
children.
What causes it?
Vesicoureteral reflux can be caused by a structural
defect, such as a ureter that did not grow to normal
size during fetal development. When this occurs, the
valve between the ureter and the bladder doesn’t close
properly, allowed urine to reflux, or flow back, into
the ureters. This is called primary vesicoureteral
reflux. Other structural defects can include an
abnormally large ureter at the point where it enters
the bladder, a ureter that does not enter the bladder
at the correct angle, and two ureters to one kidney.
The condition is called secondary vesicoureteral reflux
when it is caused by some type of blockage in the
urinary system, such as a swollen ureter due to
infection.
What are the symptoms?
Urine that travels back into the ureter can carry
bacteria to the normally sterile kidneys. The resulting
infection is what causes the symptoms of vesicoureteral
reflux. Symptoms of infection include a burning
sensation during urination, strong urge to urinate
frequently, difficulty urinating, and blood or pus in
the urine. There may also be abdominal and lower back
pain, fever, chills, and nausea. As urine backs up, it
places pressure on the kidney, which can eventually
cause kidney damage. One symptom of kidney damage is
high blood pressure. In younger children, parents may
find difficulty with toilet training. Older children
may wet the bed frequently.
How is it diagnosed?
To diagnose vesicoureteral reflux, your doctor will
test for infection in a sample of your child’s urine.
He or she will order diagnostic imaging studies of the
child’s urinary system. Some of these may be done while
the child urinates so the path from the ureters to the
bladder can be seen. The severity of the vesicoureteral
reflux is determined by the size and structure of the
ureter and how far the urine is able to flow back
toward the kidney.
What is the treatment?
Treatment for primary and secondary vesicoureteral
reflux includes daily small doses of antibiotics to
treat and prevent infection and kidney damage. Urine is
tested on a regular basis to check for infection. Your
doctor will also want to perform regular kidney exams
to ensure the kidneys are growing properly and are
undamaged. In some cases, primary vesicoureteral reflux
may improve or go away with age because the ureter
grows with the child. Surgery is recommended when
reflux is severe, the ureters are not entering the
bladder at the proper angle, kidneys are scarred or not
growing normally, or there are other structural defects
in the urinary system.
Self-care tips
At this time, there is no known way to prevent
vesicoureteral reflux. If your child has been diagnosed
with this condition, it is important to also check any
brothers or sisters. It is not unusual for
vesicoureteral reflux to occur in siblings. It is
important to identify this condition before infection
can damage the kidneys.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
|
