Vesicoureteral reflux (vesicoureteral reflux): symptoms, medications, etc.

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Definition

What is that vesicoureteral reflux (vesicoureteric reflux)?

Vesicoureteral reflux (Vesicoureteric reflux) is the backflow of urine from the bladder to the kidneys. Normally, urine flows from the kidneys to the urethra to be accommodated in the bladder.

In the urological system, the urethra and bladder muscles work so that during the process of urine formation, urine does not flow back up.

Vesicoureteric reflux is generally diagnosed since childhood. This condition usually does not have long-term effects, but children who do experience it are more susceptible to urinary tract infections (UTIs).

This is because the back flow of urine can carry bacteria in the urine into the upper urinary tract or even the kidneys. If allowed to continue, this condition can lead to infection, injury, and kidney disease.

Signs & symptoms

What are the signs and symptoms vesicoureteral reflux?

The most common symptom of vesicoureteric reflux is urinary tract infection. Globally, one in three children diagnosed with a urinary tract infection is known to have had previous vesicoureteric reflux.

Symptoms of a UTI include fever, pain or heat when urinating, frequent urination, and feeling incomplete after urinating. However, the diagnosis may not be easy because the most common symptom of a UTI in children is fever.

There may also be other signs and symptoms not listed above. If your baby has a fever for no apparent reason or you are worried about a certain symptom, try consulting a doctor.

When should I see a doctor?

Immediately see a doctor if you or your child has symptoms of a urinary tract infection. Examination of the bladder (cystoscopy) can determine whether a UTI is accompanied by vesicoureteral reflux.

You should also see a doctor immediately if your child has any of the following conditions.

• They are less than 3 months old and their rectal temperature (measured from the anus) reaches 38 degrees Celsius or more.
• Are 3 months or older, have a fever above 38 degrees Celsius, and appear unwell.
• No appetite or change mood quickly.

Cause

What causes vesicoureteral reflux?

Vesicoureteric reflux is divided into two types, namely primary and secondary. Here are the causes that differentiate the two.

1. Primary vesicoureteral reflux (VU

Most cases of VUR are primary VUR which presents as a birth defect. Children who have primary VUR are born with abnormal ureters. This condition can usually be detected when the baby is born.

The ureters are the tubes that carry urine from the kidneys to the bladder. The normal ureter has a valve to prevent urine from flowing back up to the kidneys. In primary VUR, this valve fails to close causing urine to flow in the wrong direction.

Primary VUR can improve or even go away on its own as the child grows up. This is because as we get older, the muscles that make up the ureters get stronger and the valves work better.

2. Secondary vesicoureteral reflux (Secondary VUR)

Secondary VUR results from conditions that cause obstruction or narrowing of the bladder (bladder outlet obstruction) or urethra. Causes can stem from urethral surgery, injury, or a history of infection affecting the bladder.

Secondary VUR is more common in children with birth defects, eg spina bifida. This condition can also be caused by nerve disorders of the bladder so that the bladder cannot contract properly.

Who is more at risk of developing this condition?

There are many factors that increase the risk of developing vesicoureteric reflux. Here are among them.

• Children of the Caucasian race (white people).
• Are female. However, primary VUR is more common in male infants.
• Infants and toddlers under one year. This group is more vulnerable than children who are older.
• There is a history of VUR in parents and siblings.

Medicine and medication

How vesicoureteral reflux diagnosed?

Vesicoureteric reflux is diagnosed through a urine test that also detects symptoms of a urinary tract infection. If needed, the doctor can also perform other examinations as follows.

1. Ultrasound of the kidneys and bladder

An ultrasound uses high-frequency sound waves to produce images of the kidneys and bladder. This method can detect abnormalities in the urinary tract that are a key feature of primary VUR.

2. Voiding cystourethrogram (VCUG)

This test uses X-rays to scan the bladder when it is filled with fluid and when it is empty to detect abnormalities. The doctor will insert a catheter into the bladder to drain the dye that is visible on the x-ray.

The catheter is then removed so you can urinate. At the same time, x-rays are continuously taken to see if the bladder is functioning normally. This procedure may be uncomfortable, but it's still relatively safe.

3. Nuclear scan

This method is similar to VCUG, but does not use a special dye. The doctor will detect abnormalities in the structure of the bladder with a radiation or isotope detector.

The risk of this procedure is discomfort during the urinary catheter insertion and when urinating. Your urine may also be reddish for 1-2 days after the test.

The severity of VUR can be determined through examination. VUR is mild when the backflow of urine reaches only the urethra. More severe VUR may involve severe kidney swelling (hydronephrosis) or a twisted urethra.

What are the treatment options for this disease?

Most cases of VUR do not require special treatment. Over time, your child's urinary tract will develop so that a mild VUR may disappear completely when the child is 5 years old.

Some children may need antibiotics to treat infections and prevent injuries that can cause kidney damage. Follow-up tests during treatment with antibiotics may be needed to determine the condition of the urinary tract.

Surgery to construct a new urethral tube may be needed to treat more severe cases of VUR. Surgery is also recommended if the child continues to have a UTI despite taking antibiotics or can't take antibiotics because of allergies.

Home remedies

What are the home remedies to overcome vesicoureteral reflux?

The following lifestyle changes can help you manage vesicoureteric reflux.

• Increase drinking water to thin urine and flush bacteria while maintaining bladder health.
• Avoid drinking juices, energy drinks, tea, and soft drinks until the infection clears.
• Compress the stomach with a washcloth or towel soaked in warm water to relieve pain from UTIs.

Vesicoureteral reflux mild ones are actually harmless, but this condition can get worse if left untreated. Severe VUR not only interferes with urine flow, but can also cause complications in the kidneys.

If you or your child has symptoms of a UTI, see a doctor immediately for treatment. Further tests will also determine whether a UTI is present with vesicoureteric reflux.