Vesicouretral Reflux

Because I would like to become a doctor someday, I will be talking about a common disease that I have never really heard of. I want to become a pediatrician, but I am not quite sure what specialty within pediatrics that I would like to study.

Vesicouretral Reflux (VUR) is a common urinary system disorder among children. The most commonly affected structure is the kidneys. Vesicouretral reflux occurs when urine does not flow from the kidneys into the ureters, but instead goes backwards, causing the urine to become backed up in the kidneys. The muscles in the bladder and ureter are weak allowing low amounts of pressure coming from the bladder to push the urine into the kidneys again. Some signs and symptoms of VUR, in most cases, are none. However, sometimes children with VUR will have a Urinary Tract Infection, and frequent urination.

This picture shows the different grades of the disease that you can have. It shows the inflammation and urine build up inside the ureters. The far right shows a kidney and ureter without Vesicouretral reflex.

There are two types of VUR, primary VUR and secondary VUR. The most common is primary VUR, where an infant is born with a defect at the end of a ureter valve. Secondary VUR can be acquired at any age, and mainly caused by injuries, surgery, or a past infection. Diagnosing Vesicouretral Reflux can be diagnosed by a Voiding Cystourethrogram (X-ray of urethra and bladder while urinating), a Radionuclide Cystogram (adding radioactive material into the bladder), and an abdominal ultrasound. VUR cannot be prevented; however you can avoid further complications leading to bladder and kidney infections. Many times, studies have shown that the disorder can be passed from parent to child.

 

Untreated Vesicouretral Reflux can lead to hydronephrosis, or the swelling of the top of the ureter, kidney damage, possible twisting of the ureter, and sometimes possible surgery to repair the valves in the kidney. Kidney damage occurs because VUR lets bacteria into the kidneys. Most times, VUR goes untreated. However, when the disorder is found, the patient is commonly put on antibiotics until the infection subsides. We want our children happy and healthy!