Overview
Vesicoureteral reflux is the abnormal backflow of urine from the tubes (ureters) that connect your kidneys to the bladder. Typically, urine travels from the kidneys through the ureters and bladder.
Infants and kids are the specific age groups for getting affected by vesicoureteral reflux. This condition raises the possibility of urinary tract infections, which can harm the kidneys if unchecked.
Vesicoureteral reflux (VUR) primarily affects newborns, infants and young children under the age of two, but it can also affect older children and adults. VUR is more common in kids with malfunctioning kidneys or urinary systems. Girls experience the disease more frequently than boys do.
Causes of Vesicoureteral reflux
In general, the kidneys, ureters, bladder and urethra are all parts of the urinary system. All contribute to your body excreting waste through urine.
Urine is transported from the kidneys through the tubes called ureters to the bladder, where it is held until urination. It leaves the body through the urethra. In general, primary and secondary vesicoureteral reflux are the two forms that can occur.
Primary vesicoureteral reflux
A deficiency in the valve that typically prevents urine from flowing backwards from the bladder into the ureters is said to be primary vesicoureteral reflux. It is commonly present in newborns. Primary vesicoureteral reflux is the most typical kind of reflux.
Primary vesicoureteral reflux happens when the ureters lengthen and straighten as the child develops, which may enhance valve performance and ultimately stop the reflux. This particular form of vesicoureteral reflux frequently runs in families who are already affected by the condition.
Secondary vesicoureteral reflux
Secondary vesicoureteral reflux is a type of reflux frequently brought on by the bladder's inability to empty completely. This happens due to blockage or malfunctioning of the bladder muscle.
Symptoms of Vesicoureteral reflux
People with vesicoureteral reflux frequently get urinary tract infections. Even though the majority of people have some, a urinary tract infection (UTI) does not always result in obvious signs and symptoms.
However, the following are said to be some of the warning signs and symptoms
- Intense, constant urge to urinate
- Uncomfortable burning when urinating
- The urgency to often urinate in small amounts
- Fever and cloudy urine
- Pain in abdomen
The other warning signs and symptoms of a UTI in newborns include:
- Undiagnosed fever
- Loss of appetite
- Irritation in abdomen
Untreated vesicoureteral reflux in your child can result in the following.
- Bed-wetting
- Loss of control over bowel movements or constipation
- Elevated blood pressure
Risk factors for Vesicoureteral reflux
Vesicoureteral reflux includes the following risk factors.
Bowel and bladder issues (BBD)
Recurrent urinary tract infections and holding of urine and stools in children with Bowel and bladder issues (BBD) can cause vesicoureteral reflux.
Sex
In general, males and females are more likely to be affected by vesicoureteral reflux.
Vesicoureteral reflux grading system
To determine the degree of reflux, the doctor examines an X-ray of the urinary system. This helps the doctor choose the best course of treatment by demonstrating how much urine is returning to the kidneys and ureters.
The International Study Classification, which is the most widely used grading scheme, has classified this condition into five grades.
Grade 1: In Grade I, urine reflux into the ureter.
Grade II: In grade 2, urine refluxes into the renal pelvis.
Grade III: In grade 3, moderate oedema brought on by reflux is passed into the ureter and renal pelvis.
Grade IV: In grade 4, mild oedema is produced.
Grade V: In grade 5, it causes the ureter to twist and bulge severely.
Treatment for Vesicoureteral reflux
Depending on how severe the disease is, there are different vesicoureteral reflux treatment options. Primary vesicoureteral reflux in children who have mild instances may gradually go away. Your doctor might advise a wait-and-see strategy in this situation.
Other than that, the doctor may also suggest some medications to treat Vesicoureteral reflux.
Non-surgical method
Medications are one of the recommended ways to treat vesicoureteral reflux.
Medications
To prevent the infection from spreading to the kidneys, UTIs need to be treated right away with medicines. Doctors may also recommend antibiotics at a lower dose for UTI prevention than for infection treatment.
As long as a child receives medical treatment, including antibiotics, they must be closely watched. This entails routine physical examinations, urine tests and radiographic scans of the bladder and kidneys to check for signs of UTIs that persist despite antibiotic treatment and to see if your child has outgrown vesicoureteral reflux.
Surgical method
Surgery to treat vesicoureteral reflux restores function to the valve that connects each affected ureter to the bladder. The valve has a flaw that prevents it from shutting, allowing urine to flow backwards. Some of the commonly practiced surgical techniques includes the following.
Open surgery
This procedure is carried out under general anaesthesia and calls for a lower abdominal incision through which the doctor makes the necessary surgery.
Although vesicoureteral reflux may recur in a small percentage of kids, it typically goes away on its own without further treatment.
Robotic-assisted laparoscopic surgery
This treatment is similar to open surgery and repairs the valve between the ureter and the bladder through small incisions. However, early results indicate that the success rate of robotic-assisted laparoscopic surgery may not be as high as that of open surgery.
Endoscopic surgery
In order to view the child's bladder during the surgery, the doctor inserts a tube attached with light (cystoscope) into the urethra. Next, the doctor injects a bulking agent around the damaged ureter's opening to make the valve more likely to close properly.
Though it might not be as successful, this procedure is less risky and invasive than open surgery. General anaesthesia is also required for this procedure; however, it is typically an outpatient surgery.
Preventing Vesicoureteral reflux
Vesicoureteral reflux (VUR) cannot be prevented with food, lifestyle modifications or medications. However, you may take action to enhance your child's general urinary tract health. Make certain your kid has the following.
- Adequate hydration
- Seeks prompt medical attention for urine
- Assist the child in maintaining overall health
- Encourage physical activity
When to see a doctor for vesicoureteral reflux?
To determine the degree of risk for kidney damage in children with reflux, a thorough urological history and physical examination are performed. This aids in choosing the right kind of treatment.
The doctor will inquire about vital details like:
- Whether the child is consistently urinating
- Whether the youngster has regular daytime bladder control
- Whether the kid is constipated
Conclusion
Remember that vesicoureteral reflux (VUR) isn't typically uncomfortable or dangerous. It is controllable, and treatments are frequently effective. There is no way to stop it but to preserve overall health, ensure your child drinks lots of water, engages in physical activity and consumes wholesome foods.
FAQs
How common is Vesicoureteral reflux?
What causes Vesicoureteral reflux (VUR) in adults?
What types of exams are necessary to identify vesicoureteral reflux?
High-frequency sound waves are used in this imaging technique to produce images of the kidney and bladder.
Particular urinary tract system X-ray
This examination employs X-rays of the bladder during its full and empty states to look for anomalies.
