Diagnosis and treatment of vesicoureteral reflux

The article was consulted professionally by Doctor Department of General Surgery and Anesthesia, Vinmec Hai Phong International General Hospital.

Backflow of urine from the bladder into the kidneys is called vesicoureteral reflux, which is often associated with infection, hydronephrosis, and kidney abnormalities (renal atrophy). If vesicoureteral reflux is not diagnosed and treated early, patients can develop infection and kidney failure. Early diagnosis of vesicoureteral reflux is the primary goal of monitoring and treatment.

1.1. Diagnosis based on clinical symptoms Some common manifestations in patients with vesicoureteral reflux are:
Feeling of needing to urinate more often and for a long time; Painful urination, often holding urine due to painful urination; Frequent urination, small amount of urine each time; Blood in the urine or cloudy, strong-smelling urine; Fever; Pain in the back or abdomen; Infected infants have fever, diarrhea, poor appetite and fussiness; Older children have symptoms of bedwetting, constipation and kidney failure,... 1.2. Diagnosis is based on laboratory tests Ultrasound of the kidneys and bladder: See if the ureters and kidneys are dilated, if the ureters are dilated and the kidneys are waterlogged, then reflux is suspected. X-ray of the bladder - urethra when urinating: Helps the doctor see the patient's bladder, kidneys and ureters. During the procedure, the doctor inserts a small tube into the patient's bladder and then inserts contrast material into the bladder through the tube. This fluid will show up on the X-ray when the bladder is filled and when the patient urinates; Cystography with radiation: Used for patients with urinary tract infections. With this therapy, a doctor puts a small amount of radioactive drug into the patient's bloodstream through an intravenous line. Then, your doctor will take pictures of your kidneys and bladder with special equipment. This test helps to detect scars in the kidney, allowing a definitive diagnosis of vesicoureteral reflux; Intravenous pyelonephritis: Used to observe the kidneys and urinary tract. The method of testing to be performed will be chosen depending on the patient's age, sex, number of urinary tract infections and severity of infection.

Treatment modality depends on the severity - mildness of vesicoureteral reflux disease. Specifically:
For primary vesicoureteral reflux: If the level is mild, the disease can resolve on its own when the child grows up. Pediatric patients may be prescribed additional medications to treat urinary tract infections. In children with recurrent urinary tract infections, the doctor may consider surgery to correct the problem of the valve foreign body between the bladder and the ureter, lengthening the segment of the ureter that runs through the bladder wall so that The bladder is full, urine does not back up into the ureters. In addition, children who develop new scars on their kidneys and have abnormal urinary tract structures will need surgery;
For secondary vesicoureteral reflux: Treat the cause of the disease (surgery to remove the obstructing tumor,...), combine the use of antibiotics to treat and prevent infection urinary tract if present. The patient may be catheterized to rapidly drain urine that has accumulated in the bladder.
When a child has a urinary tract infection with symptoms such as fever, burning pain when urinating, cloudy urine, diarrhea, etc., parents are not allowed to buy medicine for the child to take orally but need to take the child to a medical facility. for proper examination and treatment. If detected and treated too late, the child's kidneys may atrophy, decline in function, and require hemodialysis. At the same time, when treating vesicoureteral reflux, patients need to examine and take medicine exactly as prescribed by the doctor to limit antibiotic resistance.

When parents see that their child has signs of vesicoureteral reflux, they can take the child to Vinmec International General Hospital for examination and treatment. There is a team of well-trained, professional and experienced gynecologists; system of modern equipment, meeting international standards; Professional service quality, helping the diagnosis and treatment process to be highly effective.