Vesicoureteral (ves-ih-koe-yoo-REE-tur-ul) reflux is the abnormal flow of urine from your bladder back up the tubes (ureters) that connect your kidneys to your bladder. Normally, urine flows only down from your kidneys to your bladder.
Vesicoureteral reflux is usually diagnosed in infants and children. The disorder increases the risk of urinary tract infections, which, if left untreated, can lead to kidney damage.
Vesicoureteral reflux can be primary or secondary. Children with primary vesicoureteral reflux are born with a defect in the valve that normally prevents urine from flowing backward from the bladder into the ureters. Secondary vesicoureteral reflux is due to a urinary tract malfunction, often caused by infection.
Children may outgrow primary vesicoureteral reflux. Treatment, which includes medication or surgery, aims at preventing kidney damage.
Source: http://www.mayoclinic.com
Urinary tract infections commonly occur in people with vesicoureteral reflux. A urinary tract infection (UTI) doesn't always cause noticeable signs and symptoms, though most people have some.
These signs and symptoms can include:
A UTI may be difficult to diagnose in children, who may have only nonspecific signs and symptoms. Signs and symptoms in infants with a UTI may also include:
As your child gets older, untreated vesicoureteral reflux can lead to other signs and symptoms, including:
Another indication of vesicoureteral reflux, which may be detected before birth by sonogram, is swelling of the kidneys or the urine-collecting structures of one or both kidneys (hydronephrosis) in the fetus, caused by the backup of urine into the kidneys.
Contact your doctor right away if your child develops any of the signs or symptoms of a UTI, such as:
Call your doctor about fever if your child:
In addition, call your doctor immediately if your infant has the following signs or symptoms:
Source: http://www.mayoclinic.com
Your urinary system includes your kidneys, ureters, bladder and urethra. All play a role in removing waste products from your body.
The kidneys, a pair of bean-shaped organs at the back of your upper abdomen, filter waste, water and electrolytes — minerals, such as sodium, calcium and potassium, that help maintain the balance of fluids in your body — from your blood.
Tubes called ureters carry urine from your kidneys down to your bladder, where it is stored until it exits the body through another tube (the urethra) during urination.
Vesicoureteral reflux can develop in two forms, primary and secondary:
Primary vesicoureteral reflux. The cause of this more common form is a defect that's present before birth (congenital). The defect is in the functional valve between the bladder and a ureter that normally closes to prevent urine from flowing backward.
As your child grows, the ureters lengthen and straighten, which may improve valve function and eventually resolve the reflux. This type of vesicoureteral reflux tends to run in families, which indicates that it may be genetic, but the exact cause of the defect is unknown.
Primary vesicoureteral reflux. The cause of this more common form is a defect that's present before birth (congenital). The defect is in the functional valve between the bladder and a ureter that normally closes to prevent urine from flowing backward.
As your child grows, the ureters lengthen and straighten, which may improve valve function and eventually resolve the reflux. This type of vesicoureteral reflux tends to run in families, which indicates that it may be genetic, but the exact cause of the defect is unknown.
Source: http://www.mayoclinic.com
Urinalysis — lab analysis of a urine sample — can reveal whether your child has a UTI. Other tests are necessary to determine the presence of vesicoureteral reflux, including:
Kidney and bladder ultrasound. Also called sonography, this imaging method uses high-frequency sound waves to produce images of the kidney and bladder. Ultrasound can detect structural abnormalities.
This same technology, often used during pregnancy to monitor fetal development, may also reveal swollen kidneys in the baby, an indication of primary vesicoureteral reflux.
Voiding cystourethrogram (VCUG). This test uses X-rays of the bladder when it's full and when it's emptying to detect abnormalities. A thin, flexible tube (catheter) is inserted through the urethra and into the bladder while your child lies on his or her back on an X-ray table.
After contrast dye is injected into the bladder through the catheter, your child's bladder is X-rayed in various positions. Then the catheter is removed so that your child can urinate, and more X-rays are taken of the bladder and urethra during urination to see whether the urinary tract is functioning correctly.
Risks associated with this test include discomfort from the catheter or from having a full bladder and the possibility of a new urinary tract infection.
Nuclear scan. This test, known as radionuclide cystogram, uses a procedure similar to that used for VCUG, except that instead of dye being injected into your child's bladder through the catheter, this test uses a radioactive tracer (radioisotope). The scanner detects the tracer and shows whether the urinary tract is functioning correctly.
Risks include discomfort from the catheter and discomfort during urination. Your child's urine may be slightly pink for a day or two after the test.
Kidney and bladder ultrasound. Also called sonography, this imaging method uses high-frequency sound waves to produce images of the kidney and bladder. Ultrasound can detect structural abnormalities.
This same technology, often used during pregnancy to monitor fetal development, may also reveal swollen kidneys in the baby, an indication of primary vesicoureteral reflux.
Voiding cystourethrogram (VCUG). This test uses X-rays of the bladder when it's full and when it's emptying to detect abnormalities. A thin, flexible tube (catheter) is inserted through the urethra and into the bladder while your child lies on his or her back on an X-ray table.
After contrast dye is injected into the bladder through the catheter, your child's bladder is X-rayed in various positions. Then the catheter is removed so that your child can urinate, and more X-rays are taken of the bladder and urethra during urination to see whether the urinary tract is functioning correctly.
Risks associated with this test include discomfort from the catheter or from having a full bladder and the possibility of a new urinary tract infection.
Nuclear scan. This test, known as radionuclide cystogram, uses a procedure similar to that used for VCUG, except that instead of dye being injected into your child's bladder through the catheter, this test uses a radioactive tracer (radioisotope). The scanner detects the tracer and shows whether the urinary tract is functioning correctly.
Risks include discomfort from the catheter and discomfort during urination. Your child's urine may be slightly pink for a day or two after the test.
Doctors grade vesicoureteral reflux according to the degree of reflux. In the mildest cases, urine backs up only to the ureter (grade I). The most severe cases involve severe kidney swelling (hydronephrosis) and twisting of the ureter (grade V).
Source: http://www.mayoclinic.com
Kidney damage is the primary concern with vesicoureteral reflux. The more severe the reflux, the more serious the complications are likely to be.
Complications may include:
Kidney (renal) scarring. Untreated UTIs can lead to scarring, also known as reflux nephropathy, which is permanent damage to kidney tissue. A backup of urine exposes the kidneys to higher than normal pressure.
If your kidneys are infected, this can lead to scarring over time. Extensive scarring may lead to high blood pressure and kidney failure.
Kidney (renal) scarring. Untreated UTIs can lead to scarring, also known as reflux nephropathy, which is permanent damage to kidney tissue. A backup of urine exposes the kidneys to higher than normal pressure.
If your kidneys are infected, this can lead to scarring over time. Extensive scarring may lead to high blood pressure and kidney failure.
Source: http://www.mayoclinic.com
Urinary tract infections, which are so common to vesicoureteral reflux, can be painful. But you can take steps to ease your child's discomfort until antibiotics clear the infection. They include:
Encourage your child to drink fluids, particularly water. Drinking water dilutes urine and may help flush out bacteria.
Avoid juices and soft drinks containing citrus and caffeine until your child's infection has cleared. They can irritate the bladder and tend to aggravate the frequent or urgent need to urinate.
Encourage your child to drink fluids, particularly water. Drinking water dilutes urine and may help flush out bacteria.
Avoid juices and soft drinks containing citrus and caffeine until your child's infection has cleared. They can irritate the bladder and tend to aggravate the frequent or urgent need to urinate.
Source: http://www.mayoclinic.com
Risk factors for vesicoureteral reflux include:
Family history. Primary vesicoureteral reflux tends to run in families. Children whose parents had the condition are at higher risk of developing it.
Siblings of children who have the condition also are at higher risk, so your doctor may recommend screening for the siblings of a child with primary vesicoureteral reflux.
Family history. Primary vesicoureteral reflux tends to run in families. Children whose parents had the condition are at higher risk of developing it.
Siblings of children who have the condition also are at higher risk, so your doctor may recommend screening for the siblings of a child with primary vesicoureteral reflux.
Source: http://www.mayoclinic.com
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