VU Vesicoureteral Reflux

Vesicoureteral VU reflux is the reverse/ backward flow of the urine from the bladder through the ureter to the kidney due to a small non- functioning valve. Vesico means bladder, ureteral means ureter. Reflux is a silent problem and hence a bit tricky to diagnose.

Types & Causes :

  • Cogenital- From birth (Prenatal).
  • Kidney damage.
  • Scarring.
  • Hereditary.
  • Gender: Girls are highly susceptible.
  • Fair skinned children are highly susceptible.
  • Abnormal attachment of ureter to bladder.

Symptoms :

  • Prenatal:
  • Ballooned/ dilated kidney.
  • Mild To Moderate VU Reflux:
  • Anorexia.
  • Diarrhea.
  • Vomiting.
  • Lethargy.
  • Abdominal aches.
  • Urinary incontinence.
  • Abdominal discomfort.
  • Fever.
  • Severe VU Reflux:
  • Congestive heart failure.
  • Renal failure.
  • Hypertension.
  • Headaches.

Diagnosis Tests :

  • Urine analysis.
  • Urine culture.
  • VCUG Voiding cystourethrography.
  • PVR Post- void residual.
  • DMSA scan.
  • Renal ultrasound.
  • X-rays.
  • Imaging tests.

Stages :

  • Grade I: Non- dilated ureter reflux.
  • Grade II: Non- dilated renal calyces/ pelvis reflux.
  • Grade III: Mild to moderate dilation/ fornices blunting reflux.
  • Grade IV: Dilation of & moderate ureteral tortuosity reflux.
  • Grade V: Gross dilation of calyces/ pelvis/ ureter, pelvis, ureteral tortuosity, papillary impressions loss.

Treatment :

  • Low grade reflux:
  • VUR ie Vesicoureteral reflux.
  • Surveillance.
  • Medical treatment.
  • Reflux nephropathy.
  • High Grade Relux:
  • Surgery treatment.
  • Intravesical/ extravesical open antireflux surgery (reconstruction of UV junction).
  • Endoscopic antireflux surgery.
  • Prophylactic antibiotics
  • Anticholinergic medication.
  • Cephalosporin medication.

Risks :

  • New scars.
  • Obstructive renal growth.

Prevention & Precaution is Better than Cure:

Regularly monitor bladder/ kidney functions.

Alternative Therapies:

Psychological counseling.

All above, treatments are finalized taking into consideration the overall health, severity, age and other ailments of the patient.