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Dr. Prabhu Karunakaran

Consultant Pediatric Urologist in Hyderabad

Dr. Prabhu Karunakaran

Consultant Pediatric Urologist in Hyderabad

Vesicoureteral Reflux in Children

Vesicoureteral reflux (VUR) is a condition in which urine flows backward from the bladder into the ureters and kidneys. It is one of the most common causes of urinary tract infections (UTIs) in children. If untreated, VUR can lead to kidney scarring and long-term functional deterioration of the affected kidney.

Causes of VUR

VUR can be categorized into two main types:

  1. Primary VUR:
    • The exact cause is often unknown.
    • It is usually due to a congenital defect in the valve mechanism between the bladder and the ureter, which allows urine to flow backward.
  2. Secondary VUR:
    • Caused by other underlying conditions such as:
      • Constipation: Increased pressure in the abdomen can affect bladder function.
      • Abnormal Urine Voiding Patterns: Improper emptying of the bladder.
      • Posterior Urethral Valves: A congenital obstruction in the urethra that blocks urine flow.

Symptoms of VUR

VUR is often detected incidentally during evaluations for other issues, such as:

  • Recurrent UTIs:
    • Repeated episodes of UTIs are a common sign of VUR.
  • Slow Growth:
    • Children with VUR may show delayed physical growth due to chronic kidney issues.
  • Tummy Pain:
    • Evaluations for abdominal pain may reveal VUR.

Diagnosis

To confirm VUR, pediatric urologists may perform:

  • Imaging Tests:
    • Voiding cystourethrogram (VCUG): A specialized X-ray to visualize urine flow.
    • Ultrasound: To check for kidney size, shape, and any damage.
    • Nuclear scans like DMSA: To assess the damage to the kidney.
  • Urine Tests:
    • To detect infections and evaluate kidney function.

Treatment Options

The treatment of VUR depends on the severity of the condition, which is graded from mild (Grade I) to severe (Grade V):

  1. For Minor Grades (I-II):
    • Often requires no intervention.
    • Low-Dose Antibiotics:
      • May be prescribed to prevent recurrent UTIs.
    • Regular Monitoring:
      • Follow-ups to ensure the condition resolves naturally as the child grows.
  2. For Higher Grades (III-V):
    • Endoscopic Treatment:
      • A minimally invasive procedure to correct the reflux by injecting a bulking agent near the ureteral opening.
    • Surgical Intervention:
      • Ureteral reimplantation surgery to correct the abnormal valve mechanism and prevent reflux.

Importance of Early Treatment

Timely diagnosis and management by a Pediatric Urologist is crucial to:

  • Prevent kidney scarring and chronic kidney disease.
  • Reduce the risk of recurrent UTIs.
  • Ensure healthy growth and development in children.

If you suspect your child has VUR or notice signs of recurrent UTIs or slow growth, consult a pediatric urologist promptly for a thorough evaluation and treatment.

For expert care, contact: Dr. Prabhu Karunakaran, Consultant Pediatric Urologist and Robotic Surgeon, Hyderabad.

Visit: https://drprabhukarunakaran.com/appointment-form/

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