Vesicoureteral Reflex occurs when the urine goes the wrong way, when the urine from the bladder goes back up to the ureter and to the kidney.
Causes:
A flap valve which is located where the ureter joins the bladder, when this flap valve does not work right, which allows the back flow of the urine. Birth defects which short flap valve, genetic, abnormal baldder function in spina bifida and urinary abnormalities are the causes of Vesicoureteral Reflex VUR.
Symptoms:
Includes frequent UTI’s with pain or burning during urination, blood in urine, fever with sudden and frequent urination.
Diagnosis:
Urine analysis to check for UTI and other imaging tests include. Kidney and bladder ultrasound and nuclear scans are performed.
VCUG: This procedure is done after a dye is injected into the bladder through a catheter by using X – rays of balder when it’s full and when its empty to detect the urination pattern.
Medical management is for grade 1 and grade 2 Vesicoureteral Reflex prophylactic antibiotics are prescribed by a urologist to prevent the breakthrough of infection if not surgical management is recommended
Surgical Management:
Laparoscopic / Open Ureteral Reimplantation-
This surgery is performed to change the position of ureters at the point where it joins the bladder. It is performed under general anesthesia, in open method an incision is made in the lower part of the abdomen above the pubic bone and in laparoscopic method ports are used to reimplant the ureter into the bladder by various method then the wounds are been sutured by stitches and covered by the simple dressing.
Endoscopic surgery / Injection Deflux:
In this procedure urologist inserts a cystoscope through the urethra to visualize the bladder, then injects deflux around the opening to strengthen the valves ability to close.
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