Page 128 - Urological Health

Surgical options:

Kids diagnosed with VUR are generally followed by a urologist. Most children will grow out of VUR
and stay infection free. Few children have recurrent UTIs. Reflux should be surgically treated in this
group to prevent kidney damage.
The surgical options are:

• Injection of a bulking substance under the ureter opening into the bladder. This is done
under general anesthetic with a surgical camera (cystoscope). This will give the ureter
more support and help eliminate VUR. This procedure is very short and safe (Figure 3).
• If the endoscopic method fails or the reflux is very severe, a ureteral reimplantation may
be required. In this surgery one or both ureters are reattached to the bladder to decrease
backflow of urine from the bladder to the ureters and kidneys. The success of ureteral
reimplantation is greater than 90%, but is only used in a small number of patients.

8) PreventionUNDER REVIEW

Figure 3.

• Encourage your child to drink lots of fluids, mostly water.

• Have your child go to the bathroom to urinate six or seven times a day.
• In the bathroom, encourage your child to relax and take their time to empty his or her
bladder completely.
• Prevent your child from getting constipated. Drinking fluids is important. Eating high
fibre foods can also help. Foods with high fibre are fruits, vegetables and whole grain
breads and cereals.
• If you child has a bubble bath or uses strong soap, ensure that the opening of the urethra
is rinsed off completely. Once the irritation begins, it can become painful to urinate,
causing the child to hold her urine.
• Keep your child’s bottom clean and dry. Change diapers whenever they are wet or dirty.
Change underpants daily and whenever wet or dirty.
• Clean the penis with water every day. If the boy is not circumcised, pull the foreskin back
only if this is not causing pain and clean the under surface with water at least once a day.
• For girls, wipe the bottom from front to back each time she pees or has a bowel
movement. Each day in the bath or shower, gently wash around the labia.

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