Some children are born with vesicoureteral reflux, in which urine “backwashes” up the ureters toward the kidneys. Many children grow out of their reflux with age.
Alone, reflux is not dangerous. However, a simple urinary infection can turn into a kidney infection if bacteria wash up to the kidney.
The goal of treatment is to prevent kidney infections and kidney damage. We may recommend taking low-dose antibiotics to keep urine sterile. In severe cases, surgery may be required.
Reflux is a relatively rare condition, only affecting about 1% of children. Many children will grow out of this reflux as they get older. However, it is important to monitor the issue and take antibiotics to prevent kidney infections and kidney damage.
During infancy, the disease is more common in boys. In older children, reflux is more common in girls. It affects more Caucasian children than African-American children.
- By itself, usually no symptoms
- Most often diagnosed after a child has a urinary tract infection (UTI). Common UTI symptoms include:
- Pain or burning with urination
- Strong or foul odor to the urine
- Sudden onset of frequent urination or wetting accidents
- Abdominal or side pain
- Reflux is common among children and siblings of people with reflux. There is a strong genetic component, although no specific genes have been identified.
- Abnormal bladder function from nerve or spinal cord problems, such as spina bifida.
- Other urinary tract abnormalities such as posterior urethral valves, bladder exstrophy, ureterocele or ureter duplication.
- Children with dysfunctional voiding — bladder and bowel problems, including accidents, frequent urination or constipation.
- Blood tests
- Urinalysis and urine culture — These tests can indicate microscopic blood or protein in the urine, other chemicals, or evidence of a UTI. In children who are not toilet trained, urine may sometimes be collected with a catheter to ensure the sample is clean and pure.
- Cystogram — A catheter is placed in the bladder and the bladder is filled with fluid. This allows us to see the reverse flow of urine toward the kidney.
- Voiding cystourethrogram – An x-ray test to examine your child’s urinary tract. The bladder is filled with contrast using a catheter. X-ray images will show if there is any reverse urine flow into the ureters and kidneys.
- Renal ultrasound — Used to establish kidney size and shape and identify scars, kidney stones, cysts or other obstruction/abnormalities.
- Urodynamics – Measures bladder volume, pressure and emptying. It is performed to determine how your child’s bladder function may be contributing to the reflux.
- To prevent infections, some children take low-dose antibiotics once a day to keep urine sterile.
- Some children may need surgery too if they experience kidney infections despite preventive antibiotics or if the reflux does not resolve on its own. If surgery is necessary, we will use minimally invasive techniques.