In vesicoureteral reflux, urine flows back from the bladder to the kidneys, in the opposite direction. This may be the cause of ascending urinary tract infections with fever in children (or to a lesser extent in adults).

 

Reflux is usually caused by a congenital anatomical abnormality (primary reflux), but in rare cases it is caused by excessive pressure in the bladder (secondary reflux).

 

Diagnosis

 

If your child has one or more ascending urinary tract infections at a young age, eg kidney infections, reflux should be ruled out. Sometimes, however, reflux does not cause any symptoms at all and is accidentally seen during an ultrasound examination for other reasons.

 

In addition to an ultrasound examination of the bladder and kidneys, a cystography can also be requested. This is a radiological contrast study, in which contrast is injected into the bladder via a fine bladder probe. Afterwards, conventional radiography pictures are taken to see if that contrast flows back to the kidneys.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Therapy

 

The degree of reflux and the associated complaints (eg recurring urinary tract infections) will help determine whether treatment is necessary. This is certainly not always the case, given that reflux diagnosed at a young age can still disappear spontaneously during the next few years of life.

 

Possible treatment options are:

1. Wait and see: as mentioned above, low-grade forms of reflux can still spontaneously disappear during the first years of life.

2. Preventive antibiotics: These are a low dose of antibiotics given to the child on a daily basis to prevent new urinary tract infections.

3. Keyhole surgery with injection: a bladder examination is performed under general anesthesia, in which a voluminous product is injected under the opening of the ureter into the bladder to create a kind of valve mechanism.

4. Reimplantation: if the above measures are not eligible or prove insufficient, a reimplantation can be chosen. This means that the ureters will be detached from the bladder and re-implanted on the bladder in a different way, restoring the valve mechanism.