Vesicoureteral reflux (VUR) is a common finding in children presenting with urinary tract infection (UTI) and prenatally diagnosed urinary tract dilatation and in relatives of index patients. [pediatrics.aappublications.org]

Fever, flank or abdominal tenderness, or an enlarged palpable kidney may be present. See Clinical Presentation for more detail. Diagnosis Diagnosis of UTI depends on obtaining accurate urine culture findings. [emedicine.medscape.com]

Although urinary tract infection and flank pain were the most common presentation, others had a wide variety of complaints not directly attributable to reflux. Renal anomalies were present in 37 patients. [karger.com]

Vesicoureteral reflux may also be present. ureteroceles may be evident. If valves are present, cystoscopy should be done and the valves resected. [hawaii.edu]

The information presented can usually be covered in a typical primary care appointment. [cmaj.ca]

• Pain

  If your child has moderate to severe hydronephrosis, some symptoms may include: pain in the abdomen pain in the side (flank pain) blood in the urine ( hematuria ) A child with hydronephrosis may develop a UTI. [childrenshospital.org]

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  pain fussiness These may be less noticeable in infants. [medicalnewstoday.com]

  If your child has a fever, complains about pain below the navel or pain when urinating, or if the child goes to the bathroom more often than usual, he or she may have a urinary infection. [kidney.org]

  Other symptoms include flank pain and hypertension, uremia, and kidney failure in advanced cases of reflux nephropathy. [amboss.com]

• Asymptomatic

  Children with VUR are usually asymptomatic until they develop a urinary tract infection ( fever, dysuria, urgency.). Other symptoms include flank pain and hypertension, uremia, and kidney failure in advanced cases of reflux nephropathy. [amboss.com]

  […] infants before the age of 2 years. 32% of siblings have reflux, though the majority are asymptomatic. [urologyweb.com]

  Some children with VUR remain entirely asymptomatic, while others may develop pyelonephritis, renal scarring, and potentially progressive renal insufficiency. [dovepress.com]

  Interleukin 6 and interleukin 8 in children with febrile urinary infection and asymptomatic bacteriuria. The journal of infectious diseases 1996; 174: 1080-4. [jpma.org.pk]

  The VUR prevalence among mixed asymptomatic and symptomatic siblings was 27.7 per 100 (95% CI: 16.8, 42.2) siblings screened and 28.5 per 100 (95% CI 18.2, 41.7) asymptomatic siblings screened. [auanet.org]

• Sepsis

  Young infants may present with sepsis or fever and lack specific symptoms, whereas older children present with classical features such as dysuria, frequency and loin pain. [racgp.org.au]

  In such cases, we would treat the patient as an APN, having in mind that infections in this age can extend easily and become an APN or even sepsis. There is no agreement on the he follow-up after a first UTI. [indianjurol.com]

  To prevent sepsis, clear preoperative urine cultures of infection. If ureteral obstruction causes urosepsis, relieve the obstruction promptly and institute the appropriate antibiotics. [emedicine.medscape.com]

• Disability

  For further information, see e.g. http://www.wikihow.com/Disable-Cookies. Please be aware that disabling cookies may result in also disabling certain functionality and features of this site, as well as other websites you visit. [varsome.com]

  Complete Probemix List New and Improved Products IVD-Registered Products Bacteria Blood Cancers Cardiovascular Carrier Endocrine & Reproductive Gastrointestinal & Liver Hearing Impairment Hereditary Blood Disorders Immunological Imprinting Intellectual Disability [mlpa.com]

• Chills

  […] tract infection (in the bladder) frequent or urgent need to urinate a burning sensation while urinating blood in the urine, or urine that is cloudy or foul smelling upper tract infection (in the ureters or kidneys) pain in the side or abdomen fever and chills [kidshealth.org]

  At 2 years of age, he develops left sided abdominal pain, nausea and vomiting, without fever or chills. [hawaii.edu]

• Abdominal Pain

  pain Pyelonephritis in young children is more likely to manifest as vague abdominal discomfort rather than as the classic flank pain and tenderness observed in adults The presence of fever, while highly suggestive of pyelonephritis, is not reliable enough [emedicine.medscape.com]

  pain before or during voiding VUR is generally asymptomatic until it causes a urinary tract infection ! [amboss.com]

  When to see a doctor Parents or caregivers should consult a doctor if the child has a strong and persistent urge to urinate, experiences a burning sensation when urinating, or has abdominal or flank pain. [medicalnewstoday.com]

  They may also present at an older age with febrile UTIs, incontinence, hematuria, failure to thrive, abdominal pain, or pelvic pain. [hawaii.edu]

  Older children may also have nonspecific symptoms, such as abdominal pain or unexplained fever. A urinalysis should be obtained in a child with unexplained fever or symptoms that suggest a urinary tract infection. [aafp.org]

• Flushing

  Moreover, it also impairs flushing action. UPEC forms bacterial colonies inside uroepithelium and hence not invaded by host immune system and antibiotics resulting in recurrent UTI in the host. [journal-ina.com]

• Urinary Incontinence

  S urgical treatment of female stress urinary incontinence (SUI): AUA/SUFU Guideline. Retrieved October 24, 2017 from http://www.auanet.org/guidelines/stress-urinary-incontinence-(sui)-new-(aua/sufu-guideline-2017). [bcbst.com]

  Urinary incontinence and urinary tract infection and their resolution with treatment of chronic constipation of childhood. Pediatr 1997;100(2 Pt 1):228–32. [racgp.org.au]

  Constipation, bladder instability, urinary tract infection syndrome. Clin Nephrol. 1985;23:152–4. 20. Loening-Baucke V. Urinary incontinence and urinary tract infection and their resolution with treatment of chronic constipation of childhood. [aafp.org]

  Urinary incontinence and urinary tract infection and their resolution with treatment of chronic constipation of childhood Pediatrics 1997; 100(2 Pt 1): 228-32. [ http://dx.doi.org/10.1542/peds.100.2.228 ] [PMID: 9240804 ] - 32 Combs AJ, Van Batavia JP [benthamopen.com]

  Mittleman R, Marracini J (1983) Teflon granulomas folowing periurethral Teflon injection for urinary incontinence. Arch Pathol Lab Med 107:611–612 PubMed 71. [springermedizin.de]

The initial workup for VUR includes laboratory tests ( creatinine levels, electrolytes) and renal ultrasound for evaluation of kidney function and possible structural damage. [amboss.com]

Workup for a UTI includes a voiding cystourethrogram (VCUG) with fluoroscopic monitoring and a renal sonogram. Nuclear cystograms are useful for follow-up studies. DMSA scanning is the most accurate investigation to document inflammation and scars. [urologyweb.com]

See Workup for more detail. [emedicine.medscape.com]

[…] insufficient utility as a single diagnostic test in the evaluation of children suspected of having VUR, such as those presenting with prenatal hydronephrosis or urinary tract infection (UTI). [2] VCUG is the method of choice for grading and initial workup [en.wikipedia.org]

The goals of treatment of VUR include prevention of recurrent febrile UTI and renal injury, as well as minimizing treatment morbidity [ 4 ]. [omicsonline.org]

Bulking agents may be injected over a course of several treatments until the desired effect is achieved. S everal bulking agents have been studied for the treatment of fecal incontinence. [bcbst.com]

treatment compared with the other [14,15]. [jpss.eu]

[…] the consideration of potential adverse effects of long-term antibiotic treatment, which can include allergic reactions and development of treatment-resistant bacteria resulting in breakthrough UTIs. [bcidaho.com]

Endoscopic treatment of vesicoureteral reflux in a paediatric surgery ambulatory unit. J Minim Access Surg. 2011; 7 (2): 132-5[ DOI ][ PubMed ] 4. Lackgren G. Endoscopic treatment of vesicoureteral reflux: Current status. [intjinfection.com]

Treatment and prognosis Significant vesicoureteral reflux, if untreated, may lead to recurrent urinary tract infections, renal scarring, and eventually renal failure ( reflux nephropathy ). [radiopaedia.org]

( 30762254 ) Arlen AM...Cooper CS 2019 8 Usefulness of the classification of urinary dysfunction for the prognosis of the first endoscopic treatment of vesicoureteral reflux in children over the age of 3. ( 30833101 ) Marzullo-Zucchet L...Boronat Tormo [malacards.org]

Patients with hydronephrosis and/or reflux have an excellent prognosis today. Questions 1. What is the most common congenital condition detected by prenatal US? 2. [hawaii.edu]

Genet., 20, 1 –68. 4 Wedell, A. ( 1998 ) Molecular genetics of congenital adrenal hyperplasia (21-hydroxylase deficiency): implications for diagnosis, prognosis and treatment. [academic.oup.com]

Article / Publication Details First-Page Preview Abstract Anatomy and function of the ureterovesical opening is briefly described and an etiological classification of vesico-ureteral reflux (VUR) given. [karger.com]

Etiology Primary VUR (most common type): short intramural ureter → v esicoureteric junction (VUJ) fails to close completely during bladder contraction → VUR Secondary VUR Bladder outlet obstruction (anatomic/functional): high pressure within the bladder [amboss.com]

Familial tendency or trait in etiology of VUR has been reported, but the specific manner of inheritance is still unclear. [sjkdt.org]

In toilet-trained children with recurrent UTI, voiding postponement behaviors, incomplete emptying, and constipation are extremely common and may be much more important etiologic factors than the reflux itself. [emedicine.medscape.com]

King LR (1976) Vesicoureteral reflux: history, etiology and conservative management. In: King LR, Kelalis PP, Belman AB (eds) Clinical paediatric urology. W.B. Saunders Co. [link.springer.com]

Epidemiology References: [1] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]

An epidemiologic study of bacteriuria and blood pressure among nuns and working women. New Engl J Med 1968;278(12):635–42. Lee YJ, Lee JH, Park YS. [racgp.org.au]

Laparoscopic and robotic-assisted laparoscopic procedures are often imitation of classical open procedures in laparoscopic or robotic-assisted laparoscopic environments. [8] Epidemiology [ edit ] It has been estimated that VUR is present in more than [en.wikipedia.org]

Prenatally detected uropathy: Epidemiological consideration Br J Urol 1998; 81: 8-12. 12. Sheu JN, Chen MC, Lue KH, Cheng SL, Lee IC, Chen SM, Tsay GJ. Serum and urine levels of interleukin-6 and interleukin-8 in children with acute pyelonephritis. [jpma.org.pk]

In several large epidemiologic studies, the authors found that the incidence of significant urinary tract infections in uncircumcised males less than six months of age was 1 to 4 percent. [aafp.org]

Joint hypermobility syndromes: the pathophysiologic role of tenascin-X gene defects. Arthritis Rheum. 2004 Sep;50(9):2742-9. Review. [ghr.nlm.nih.gov]

Ureters enter the bladder at a diagonal angle and have a special one-way valve system that normally prevents urine from flowing back up the ureters in the direction of the kidneys. [stanfordchildrens.org]

In most instances, antibiotic prophylaxis and surgical intervention are not required to prevent UTIs. Rather, good hygiene, prevention of constipation, adequate fluid intake and complete bladder emptying can help to prevent most recurrences. [racgp.org.au]

But with prompt treatment, long-term complications and damage to the kidneys can be prevented. Date reviewed: March 2014 [kidshealth.org]

THERAPEUTIC GOALS IN MANAGEMENT OF REFLUX Detection Treatment of any associated voiding dysfunction Prevention of pyelonephritis Prevention of scarring Promotion of normal renal growth TREATMENT Treatment plans are individualized according to age/sex, [urologyweb.com]

Maintaining a good level of hydration prevents constipation and contributes to the prevention of UTI, as it stimulates more frequent micturition. A diet rich in fibers may help in obtaining soft stools. [emedicine.medscape.com]