When the ureters enter the bladder, they travel through the wall of the bladder creating a tunnel so that a flap-like valve is created. This valve prevents urine from backing-up into the ureters and kidneys.
In some children, the valves may be abnormal or the ureters in the bladder may not travel long enough in the bladder wall, which can cause vesicoureteral reflux (VUR).
Vesicoureteral reflux is a condition that allows urine to go back up into the ureters and kidneys causing repeat urinary tract infections. The reflux of urine exposes the ureters and kidney to infection from bacteria and high-pressure, which is generated by the bladder during urination. If left untreated, urinary infections can cause kidney damage and renal scarring with the loss of potential growth of the kidney and high blood pressure later in life.
Vesicoureteral reflux is more common in infants and young children, but older children and even adults can be affected.
In many cases, a child with VUR has no symptoms. When symptoms are present, the most common is a urinary tract infection (UTI).
There are two types of VUR; primary and secondary. Most cases of VUR are primary and typically affect only one ureter and kidney. With primary VUR, a child is born with a ureter that did not grow long enough during the child’s development in the womb. The valve formed by the ureter pressing against the bladder wall does not close properly, so urine refluxes from the bladder to the ureter and eventually to the kidney. This type of VUR can get better or disappear as a child gets older. As a child grows, the ureter gets longer and function of the valve improves.
The standard treatment for primary VUR includes prompt treatment of UTIs and long-term use of antibiotics to prevent UTIs until VUR goes away on its own. Surgery has traditionally been considered for a child with kidney infections, fevers and severe reflux that has not improved within a year.
Secondary VUR occurs when a blockage in the urinary tract causes an increase in pressure and pushes urine back up into the ureters. Children with secondary VUR often have bilateral reflux. VUR caused by a physical defect typically results from an abnormal fold of tissue in the urethra that keeps urine from flowing freely out of the bladder.
Secondary VUR is treated by removing the blockage causing the reflux. Treatment may include surgery, antibiotics or intermittent catheterization—draining the bladder by inserting a thin tube, called a catheter, through the urethra to the bladder.
Call to schedule an appointment with Prevea Urology:
Green Bay, Sturgeon Bay and Oconto Falls (920) 436-1359
Sheboygan, Plymouth and Manitowoc (920) 458-6664
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