Vesicoureteral reflux is a condition that causes urine to go backwards from the bladder up in to the kidneys. This can be a very silent problem and can lead to permanent kidney damage, hypertension, and kidney failure.
When a young infant gets a bladder infection, or when a child gets a kidney infection or recurrent bladder infections, it is important to be sure that your child does not have vesicoureteral reflux or any abnormalities of the structure of the kidneys.
There are tests that your child’s physician may order to rule out structural kidney problems and vesicoureteral reflux.
One test is a renal ultrasound. This test is not painful and does not involve any x-rays. This test shows the size and shape of the kidneys, and will usually detect any obstruction of the kidneys or abnormalities of kidney structure.
Another test is the voiding cystogram. This test requires the placement of a small catheter in your child’s urethra. Some dye is introduced into the bladder through the catheter, and then x-rays are taken of the bladder, ureters and kidneys. If reflux is present, the dye will be seen leaving the bladder and going up the ureters toward the kidneys.
The voiding cystogram involves no needles, yet the catheterization is uncomfortable to most children. Depending on the child’s age a sedative may be used for the procedure.
When a child has vesicoureteral reflux, it is generally recommended that they receive a preventive antibiotic once a day, and then the voiding cystogram is repeated at intervals until the child outgrows the reflux.
Most children outgrow vesicoureteral reflux. If the child is kept infection-free by use of the preventive antibiotics, then there is usually not permanent kidney damage.
If your child with vesicoureteral reflux has fever or symptoms of bladder infection even while on preventive antibiotics, it is essential to have a urine culture done to be sure there is no infection.
When the degree of vesicoureteral reflux is severe, or when the reflux is not improving adequately with age, referral is made to a pediatric surgeon who is familiar with the treatment of vesicoureteral reflux. There is a surgical procedure called vesicoureteral re-implantation which can be curative for persistent reflux not responding to medical therapy and time.
Copyright 1998 MCM