Page 1 - Vesicoureteric Reflux
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Urological Health

                                Vesicoureteric reflux

        Vesicoureteric reflux is a common problem in children with urinary infections.
        Surgical correction is possible in the few who will require treatment.

             our child has been found to have vesicoureteric      Investigations of VUR
        Yreflux (VUR). This is a condition, commonly
        detected during the investigation of urinary tract        Underlying urinary tract abnormalities are common
        infection (UTI) in children, in which urine can flow back   in children with urinary infections. A child who
        from the bladder toward the kidneys.                      experiences a UTI may undergo imaging studies to
                                                                  demonstrate urinary tract anatomy and determine
        Urine produced by the kidneys drains down tubes           the presence of VUR. Your doctor will recommend the
        (the ureters) into the bladder where it is stored until it   necessary investigations and their timing.
        is appropriate to empty through the urethra (“urine
        passage”). Normally, one-way “flap valves” at the         The kidneys may be examined by ultrasound, a
        junction between the ureters and the bladder prevent      painless test without x-ray exposure. The identification
        backflow of urine toward the kidneys.                     of VUR requires another test, the voiding cysto-
                                                                  urethrogram (VCUG). A small tube (catheter) is
                                                                  inserted into the child’s bladder through the urethra.
                                                                  The bladder is then filled with contrast material
                                                                  (“dye”) and x-rays are taken as your child voids.
                                                                  The appearance of contrast in the ureter or kidney
                                                                  confirms the suspicion of VUR and its severity can be

                                                                  Your doctor may recommend other tests such as a
                                                                  nuclear cystogram, which is carried out much like
                                                                  a VCUG, but exposes your child to less radiation, or
                                                                  a renal nuclear scan to accurately assess kidney
                                                                  function and the presence of scars.

                                                                  Preventive antibiotics

                                                                  In time, VUR frequently will resolve without treatment
                                                                  as the valves develop in the growing child. Many
                                                                  cases of VUR can be monitored safely without specific
                                                                  treatment as long as infection is prevented. During this
        When these valves do not develop properly,                period of observation, your doctor may recommend
        backwash of urine from the bladder to the ureter          small daily doses of antibiotics in an effort to prevent
        and kidney, vesicoureteric reflux, can occur. One         infection and kidney damage.
        or both kidneys may be involved from the time of
        birth. Usually, VUR alone will produce no symptoms or     The severity (grade) of VUR and a child’s abnormal
        cause any harm. Should your child develop a bladder       voiding habits, such as prolonged urine holding,
        infection, however, the infected urine flowing back to    will determine the duration of VUR. A child with
        the kidney(s) can cause a kidney infection. This can      VUR should be encouraged to void regularly and
        make your child quite ill with fever and chills, and,     constipation should be prevented. Usually, VUR
        may result in permanent scarring of the kidney. In most   resolves within two years for boys and four years for
        cases, urinary infection does not cause VUR, nor does     girls.
        VUR cause urinary infection.                                                         Continued on next page
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