Vesicoureteral Reflux (VUR) is a condition in which urine flows backward from the bladder into one or both ureters and sometimes into the kidneys. This abnormal flow increases the risk of recurrent urinary tract infections (UTIs) and kidney damage in children. Dr. Pruthvi Raj Honnaiah, an expert in paediatric urology, offers comprehensive evaluation and corrective treatments, ensuring optimal outcomes for children diagnosed with VUR.

What is Vesicoureteral Reflux (VUR)?

Normally, urine flows one-way from the kidneys to the bladder through the ureters. In children with VUR, the valve-like mechanism between the ureters and bladder does not function properly, allowing urine to reflux back towards the kidneys. This can lead to:

• Recurrent urinary tract infections (UTIs)
• Kidney infections (pyelonephritis)
• Kidney scarring and potential loss of kidney function if untreated

Causes and Risk Factors

VUR is often congenital (present from birth) due to improper development of the junction between the ureter and bladder. In some cases, it may develop after urinary tract infections or bladder dysfunction. Family history also plays a role, as VUR can run in families.

Symptoms and Signs

• Recurrent or persistent urinary tract infections (UTIs)
• Fever, abdominal pain, or back pain
• Pain during urination
• Foul-smelling urine
• Poor growth or failure to thrive in severe cases

Evaluation and Diagnosis

Diagnosis of VUR involves:

• Ultrasound: To check for kidney size, structure, and any abnormalities.
• Voiding Cystourethrogram (VCUG): A special X-ray that shows the bladder and ureters during urination to detect reflux.
• Nuclear Renal Scan: Occasionally used to assess kidney function and scarring.
• Urine Tests: To check for infection and kidney health.

Treatment and Correction Options

Treatment depends on the severity of reflux (graded I to V), age of the child, and presence of infections or kidney damage.

1. Conservative Management

Mild cases (Grade I-II) may resolve with time and require only regular monitoring and low-dose antibiotics to prevent infections.

2. Minimally Invasive Endoscopic Injection

For some cases, a minimally invasive procedure is performed where a bulking agent is injected near the ureteral opening to prevent urine backflow. This is done under general anesthesia with no large incisions.

3. Surgical Correction - Ureteral Reimplantation

In moderate to severe VUR (Grades III-V) or if infections persist, surgery may be required. This involves repositioning the ureter to create a more effective one-way valve between the ureter and bladder.

• Performed under general anesthesia.
• Can be done using traditional open surgery or minimally invasive (laparoscopic/robotic) techniques.
• High success rates with permanent correction.

Post-Operative Care and Follow-Up

After surgical correction, most children recover well and are monitored for:

• Urinary tract infections
• Bladder function
• Kidney health and function

Follow-up imaging, such as ultrasound or VCUG, may be done to confirm successful resolution of VUR.

Why Choose Dr. Pruthvi Raj Honnaiah?

Dr. Pruthvi Raj Honnaiah is highly experienced in the diagnosis and surgical correction of VUR in children. With a focus on minimally invasive techniques, child-friendly care, and comprehensive follow-up, he ensures the best possible outcomes for your child.