WHAT IS AN VESICOURETERAL REFLUX?
Vesicoureteral Reflux (VUR) is the abnormal flow of urine from the bladder back up to the ureters and sometimes to the kidneys. It is a condition in which the flow of urine goes the wrong way. This is more common in infants and children. Should it occur in adults, it may be associated with bladder outlet obstruction e.g. enlarged prostate (BPH) in men.
SYMPTOMS OF VESICOURETERAL REFLUX?
Vesicoureteral reflux can sometimes have no symptoms. Should there be symptoms, it can present with flank pain, sensation of fullness or sensation of incomplete emptying of the bladder after passing urine. It can lead to serious issues e.g. worsening of kidney function and recurrent urinary tract infection (UTI).
DIAGNOSING VESICOURETERAL REFLUX
The diagnosis of vesicoureteral reflux is made with a test called a voiding cystourethrogram (VCUG). It is an X-ray of the bladder which involves placing a thin catheter in the urethra and injecting fluid with an X-ray dye through the tube until the bladder is full. The patient is then asked to pass urine and pictures will be taken to see how the dye moves, specifically whether it moves backward up to one or both kidneys.
TREATMENTS FOR VESICOURETERAL REFLUX
Treatment depends on the severity of the reflux. For mild reflux, the condition can be treated conservatively, particularly in younger children e.g. 5-6 years of age. The aim of treatment with antibiotics is to prevent Urinary Tract Infection (UTI) and kidney damage. Treatment for severe cases of vesicoureteral reflux is Surgery. A minimally invasive surgical option is endoscopic surgery where the surgeon inserts a cystoscope into the urethral opening to see the inside of the bladder. A substance (bulking agent) is injected into the area where the ureter enters the bladder to try to fix the reflux. Other surgical options include reimplantation of the ureter, fixing a flap-valve attachment of the ureter to the bladder. This can be done laparoscopically or as an open surgery.