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What is vesicoureteral reflux?


Vesicoureteral reflux (VUR), also known as vesico-ureteric reflux, is a condition affecting the urinary system that usually occurs in children. Normally, urine flows from the kidneys to the bladder in one direction via tubes called ureters. However, in VUR, urine is able to reflux back up one or both ureters, sometimes even all the way to the kidneys.


 


Prognosis of vesicoureteral reflux


Vesicoureteral reflux is often associated with other urinary conditions. The kidneys can become swollen with a condition called hydronephrosis when urine repeatedly refluxes back to them.


The reflux of urine can also increase the risk of urinary tract infections (UTIs), which are more likely to spread further up the urinary tract. If these infections reach the kidneys, they can lead to kidney damage. Long-term effects can include high blood pressure and even kidney failure.


 


Symptoms of vesicoureteral reflux


VUR is usually diagnosed after the patient has suffered a series of urine infections. Symptoms of urine infections include:




The presence of hydronephrosis is also an indicator – the kidney becomes swollen with urine as it becomes backed up from the ureter and this is usually visible on scans.


In young children, the problem may be harder to spot. Signs to watch out for include unexplained fevers, any changes in urinary or bowel habits, loss of appetite, and irritability.


 


Medical tests to diagnose vesicoureteral reflux


VUR may be diagnosed by:




 


What are the causes of vesicoureteral reflux?


Vesicoureteral reflux can be one of two types:




 


Can vesicoureteral reflux be prevented?


The condition itself can’t be prevented, but the chances of UTIs can be reduced by drinking plenty of fluid and going to the toilet regularly.


 


Treatments for vesicoureteral reflux


Many children outgrow VUR – the bladder wall and ureter develop further and where the ureter’s path through the bladder wall was once too short, it can grow to fit better and allow the valve to close, preventing the reflux of urine. In such cases, a low dose of antibiotics to combat and prevent UTIs may be given for the first few years of the baby’s life until the VUR resolves itself.


In other cases, the child may continue to have severe VUR after the age of five, in which case an operation may be needed:




 


Which type of specialist treats vesicoureteral reflux?


Vesicoureteral reflux is typically treated by paediatric urologists due to the fact that it is usually diagnosed and treated in children. In adults, it may be treated by urologists.