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Urologic Conditions & Treatments

Urinary Reflux Chattanooga TN

What is vesicoureteral reflux?

Vesicoureteral reflux (VUR), more commonly known as urinary reflux, occurs when urine flows back up the ureters that connect the bladder to the kidneys. 

This condition is commonly diagnosed in young children and infants, and it is known to cause urinary tract infections and kidney infections. When left untreated, kidney infections can eventually damage the kidneys and lead to scarring. 

VUR can be diagnosed by an X-ray dye study called a voiding cystogram, or VCUG, that detects the backward flow of urine from the bladder into the kidney. Children with multiple urinary tract infections (UTI) may need a VCUG in order to make the diagnosis of VUR.

Who is at most risk for Developing Vesicoureteral Reflux (VUR)?

Children and infants are most at risk for developing vesicoureteral reflux. If a child has been diagnosed with VUR, their siblings are more likely to also have VUR. Many young children are diagnosed with vesicoureteral reflux only after a UTI has been diagnosed.

Approximately 30–45% of children and 1–2% of newborns develop UTIs, but these infections can be difficult to catch if the symptoms are nonspecific, such as a lack of appetite, irritability, or unexplained fever.

If associated with recurrent kidney infections (UTIs with high fevers), untreated vesicoureteral reflux can lead to high blood pressure or kidney damage.

What Are The Symptoms of VUR?

When a UTI is present, the usual symptoms are painful urination, fever, back pain, wetting accidents, and other urinary symptoms. Most children with VUR who get a UTI recover without long term complications. Most vesicoureteral reflux resolves spontaneously as children grow. However, if a child outgrows VUR, long term monitoring of kidney function and blood pressure is still necessary.

What causes VUR and kidney infections?

Vesicoureteral reflux is due to an abnormal connection between the ureter and bladder, allowing backflow of urine up the ureter. Bacteria may also travel up to the kidneys and cause a kidney infection. Most often, the infecting bacteria come from the colon. If a child has difficulty stooling, this affects bladder function as well as providing bacteria for infection.

Diagnosis

Urinalysis and culture, ultrasound of the kidneys, ureters and bladder, voiding cystogram (VCUG), renal scan, renal function testing, and voiding pattern studies.

How Is VUR Treated?

Treatment for VUR will depend on the patient’s age and the severity of their VUR. Diagnosing VUR will typically include a series of tests, including urinalysis and culture, voiding cystogram, scanning and testing renal function, voiding pattern studies, and ultrasounds of the kidneys, ureter, and bladder. 

All patients with VUR and problems emptying their bladder and bowels will need treatment directed at creating healthy bladder and bowel habits.

Most cases of VUR resolve on their own over time, but if the patient has VUR and problems with recurrent UTIs, they may need prophylactic antibiotics while waiting on the VUR to resolve. If the case is more severe or persistent, treatment may require surgical correction to reduce the likelihood of future infections and kidney damage. The most important goal of VUR treatment is to avoid kidney damage.

VUR cannot be prevented; however, there are certain steps you can take to help keep your child’s urinary tract healthy as they are developing. It is important they stay hydrated, urinate regularly, avoid constipation, and see a doctor for any abnormalities in their excretions, mood, and overall health.

What Are the Risk Factors Associated with VUR?

Certain people are more at risk for developing vesicoureteral reflux. Primary VUR tends to be hereditary, so patients with parents or siblings who have had the condition are more likely to develop VUR. VUR is also more likely to be diagnosed in children with bladder and bowel dysfunction or certain neurologic problems. 

In general, white children, female children, and children under the age of two are at a higher risk of being diagnosed with VUR at some point in their childhood, while male children are more likely to have VUR associated with kidney infections.

UT Urology has the only fellowship trained pediatric urologists in the region who provide care to the children of Chattanooga, Tennessee, Knoxville, TN, Alabama and northern Georgia. They are world-class, board certified pediatric surgeons who regularly treat urinary reflux through state-of-the-art medicine and surgery. Please allow us to assist in all of you pediatric urology needs and thank you for making us one of the leading urology groups in the Southeast.

If you believe your child is suffering from vesicoureteral reflux, or urinary reflux, in Chattanooga, Cleveland, and East Ridge, TN, call our office to schedule an appointment to find out what treatment is best for you.

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