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]

• 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]

• Falling

  If function falls below 15 percent of normal capacity, the patient has end-stage kidney disease, and they will need either a kidney transplant or regular dialysis. [medicalnewstoday.com]

  MyBioSource and its authorized distributors reserve the right to refuse to process any order where we reasonably believe that the intended use will fall outside of our acceptable guidelines. [mybiosource.com]

  In the first year of life, UTIs are more common in boys than girls and 10 times higher in uncircumcised boys, compared with circumcised boys. 3 The incidence of UTIs falls below 1% in school-aged boys and increases to 1–3% in school-aged girls. 4 Sexual [racgp.org.au]

  Die offen operativen Techniken sind bei weitem nicht in jedem Fall durch die subureterale Implantation von „bulking agents“ ersetzbar. [springermedizin.de]

  The major indication for revision surgery after corrective VUR surgery falls on the occurrence of a breakthrough febrile UTI. The surgical approach to revision surgery depends on surgeon preference. [f1000research.com]

• 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]

• Inguinal Hernia

  When we were in the pediatric surgery waiting room with my son (he had an inguinal hernia) most of the little girls there had a reflux problem. [mamapedia.com]

• Low Back Pain

  Complications included early fever due to urinary tract infection in 1 children, transient dysuria in 2 patients and low back pain in 1patient. The authors concluded that the success rate of PIT for treatment of high grade VUR is high. [aetna.com]

• 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]

• Fear

  We work with families' fears of prolonged antibiotics, procedures, tests and surgery. The test used to diagnose vesicoureteral reflux — the voiding cystourethrogram, or VCUG — concerns many parents because it requires uretheral catheterization. [ucsfbenioffchildrens.org]

  This technique was originally rejected in the United States amid fears of poor results, but this changed over the last few decades and the longitudinal results are equivocal to IV techniques [ 55 Austin JC, Cooper CS. [benthamopen.com]

• Flank Pain

  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]

  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]

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

  When to see a doctor Contact your doctor right away if your child develops any of the signs or symptoms of a UTI, such as: A strong, persistent urge to urinate A burning sensation when urinating Abdominal or flank pain A hesitancy to urinate Call your [mayoclinic.org]

  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]

• Cloudy Urine

  Older children may have more recognizable symptoms of UTIs, including a strong urge to urinate, painful urination or cloudy urine. If your child tends to get repeat UTIs, you may want to have him evaluated for possible urinary tract obstruction. [childrenshospital.org]

  Signs and symptoms of a bladder infection or a UTI may be: urgency to urinate a burning sensation or pain when urinating blood in the urine cloudy urine urine with a strong, unpleasant smell dribbling urine, incontinence, and bed-wetting fever and abdominal [medicalnewstoday.com]

• Anuria

  Anuria Anuria is rare and may indicate dehydration or bilateral ureteral obstruction. Provide therapy via intravenous fluid challenges and furosemide. Check ureteral catheters for patency. [emedicine.medscape.com]

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]