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Vesicoureteral Reflux (VUR)
What Is Vesicoureteral Reflux?
Vesicoureteral reflux (VUR) is when pee moves backward from the bladder to the kidneys. Normally, pee only flows from the kidneys down to the bladder. In most kids with the condition, it's not serious and they outgrow it with no lasting problems.
What Happens in Vesicoureteral Reflux?
Thin tubes called ureters (YUR-uh-ters) connect the kidneys to the bladder, and carry urine (pee) to it. The bladder stores the urine until it's emptied when we pee. While urine is in the bladder, it doesn't usually flow back into the ureters. When we pee, urine leaves the body through the urethra (yoo-REE-thruh), a tube at the bottom of the bladder.
In vesicoureteral (ves-ih-koe-yoo-REE-ter-ul) reflux, pee flows up from the bladder into the ureters and sometimes to the kidneys.
What Are the Signs & Symptoms of Vesicoureteral Reflux?
A UTI lower in the urinary system (in the bladder) can cause:
- frequent or urgent need to pee
- bedwetting and daytime pee accidents
- a burning feeling while peeing
- blood in the pee, or pee that looks cloudy or smells bad
A UTI higher in the urinary system (in the ureters or kidneys) can cause the same symptoms, as well as:
- pain in the side, back, or belly
- fever and chills
What Causes Vesicoureteral Reflux?
Primary VUR is when defects in one or both ureters let pee flow the wrong way. Most kids with VUR have this type. Babies born with primary VUR have a ureter that didn't grow long enough before birth. This can affect where the ureter enters the bladder, letting pee flow back up the ureters to reach the kidney. Primary VUR is often a genetic condition.
Secondary VUR is when a blockage in the urinary tract obstructs the flow of pee and sends it back into the kidneys. Kids with this type often have reflux in both ureters. This can happen because the bladder doesn’t empty properly, either from a blockage, an abnormal bladder muscle, or injury to the nerves that control peeing.
How Is Vesicoureteral Reflux Diagnosed?
Sometimes, doctors find the condition before a baby is born during a routine prenatal ultrasound. The test might show that the baby has hydronephrosis/urinary tract dilation, which is swelling of the kidneys and and/or the ureter (the tube that drains the kidneys into the bladder).
If your child has symptoms of a UTI, see a doctor right away. The doctor will do an exam, ask about your family medical history, and might order tests. These can include:
- Blood tests and urine tests can see how well the kidneys are working and check for signs of infection or kidney damage.
- An abdominal ultrasound uses sound waves to create images of the urinary tract. These might show signs of infection, swelling of the kidney, or a thickened bladder.
- A voiding cystourethrogram (VCUG) is a test done to specifically look for VUR It's done while the patient pees. A technician fills the bladder with a special liquid, then takes X-rays while it is filling and emptying during peeing.
- Contrast-enhanced voiding urosonography (ceVUS). As with VCUG, a catheter is placed and the bladder is filled with a special liquid. But an ultrasound is used instead of X-ray to get an image. This test uses no radiation.
If a child has VUR, the doctor will grade it from I through V. Grade I reflux is the mildest, with pee that backs up only as far as the ureters. Grade V reflux is the most severe.
How Is Vesicoureteral Reflux Treated?
Kids with mild VUR often don't need treatment. Many kids with primary VUR outgrow it. As a child gets older, the ureter gets longer and straighter, and in time will develop correctly.
Doctors use antibiotics to treat VUR that happens with a UTI. This keeps the infection from spreading to the kidneys. Kids who take antibiotics should take them for as long as prescribed, even if they start to feel better. Some kids will take antibiotics every day as a way to prevent UTIs.
The doctor might talk to you about surgery that can help kids with primary VUR. The most common type of surgery is ureteral reimplantation. In this procedure, the surgeon extends one or both ureters further into the bladder. This stops pee from flowing backward from the bladder to the ureters and kidneys. Kids who get this surgery usually spend 1–2 days in the hospital while they recover. This surgery is done through an opening under the underwear line or robotically via small incisions on the abdomen.
Another surgery, endoscopic injection, involves injecting a special gel into the bladder through a thin tube. The surgeon places the gel into the opening of the ureter. This prevents pee from going back into the ureter and helps the ureter close properly. Most kids who have this procedure can leave the hospital on the same day.
Kids with secondary VUR might get to fight infections and treatment for the main problem that led to the VUR.
What Else Should I Know?
Untreated VUR can lead to long-term problems. Backed-up pee that reaches the kidneys can cause infections that can scar them, causing:
- high blood pressure (hypertension)
- protein in the urine
- problems with how the kidneys work or kidney failure
Always call your doctor if your child has symptoms of a UTI, especially with a fever. Quick treatment of VUR can prevent long-term problems and kidney damage.
- Recurrent Urinary Tract Infections (UTIs) and Related Conditions
- Ultrasound: Renal (Kidneys, Ureters, Bladder)
- Urine Tests
- Urinary Tract Infections (UTIs)
- Ultrasound: Abdomen
- Voiding Cystourethrogram (VCUG)
Note: All information is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor.
© 1995- The Nemours Foundation. KidsHealth® is a registered trademark of The Nemours Foundation. All rights reserved.
Images sourced by The Nemours Foundation and Getty Images.
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Katika watoto wengi wenye hali hiyo, si mbaya na huikabiliana bila matatizo ya kudumu. Ni Nini Hotokea Katika Uvujaji wa Vesicoureteral? Vipande vidogo vya mkojo vinavyoitwa ureters (YUR-UH-TER) huunganisha figo na kibofu cha mkojo, na kusafirisha mkojo (pee) hadi kwenye kibofu hicho. Kibofu cha mkojo huhifadhi mkojo hadi unapopoteza maji wakati tunapotafuna. Wakati mkojo uko katika kibofu cha mkojo, kwa kawaida haurudi kwenye mkojo. Tunapotafuna mkojo, mkojo hutoka mwilini kupitia mkojo (yoo-REE-thruh), ambayo ni bomba lililo chini ya kibofu cha mkojo. Katika vesicoureteral (ves-ih-koe-yoo-REE-ter-ul) reflux, mkojo hutiririka kutoka kibofu cha mkojo hadi kwenye ureters na wakati mwingine hadi kwenye figo. Ishara na Dalili za Uvujaji wa Vesicoureteral ni Zipi? UTI ya chini ya mfumo wa mkojo (katika kibofu cha mkojo) inaweza kusababisha: - uhitaji wa mara kwa mara au wa haraka wa kuoga - kuoga kitandani na ajali za kuoga wakati wa kuoga - hisia ya kuchoma wakati wa kuoga - damu katika mkojo, au mkojo unaonekana kuwa na ukungu au harufu mbaya UTI ya juu katika mfumo wa mkojo (katika ureters au figo) inaweza kusababisha dalili sawa, pamoja na: - maumivu ya upande, mgongo, au tumbo - homa na baridi. Ugonjwa wa msingi wa mkojo (VUR) ni ugonjwa wa kuharibika kwa moja au ureters zote mbili, na kusababisha mkojo kutiririka kwa njia isiyofaa. Watoto wengi wenye VUR wana aina hii. Watoto wanaozaliwa na VUR ya msingi wana ureter ambayo haikukua kwa muda mrefu wa kutosha kabla ya kuzaliwa. Hii inaweza kuathiri mahali ambapo ureter huingia kwenye kibofu cha mkojo, ikiruhusu mkojo kutiririka nyuma kupitia ureters kufikia figo. VUR ya msingi mara nyingi ni hali ya urithi. VUR ya sekondari ni wakati blockage katika njia ya mkojo kuzuia mtiririko wa mkojo na kuupeleka nyuma katika figo. Watoto wenye ugonjwa huo mara nyingi huwa na mtiririko wa damu katika mifereji yote miwili ya mkojo. Hii inaweza kutokea kwa sababu kibofu cha mkojo haipati maji kwa usahihi, ama kutokana na kizuizi, misuli ya kibofu cha mkojo isiyo ya kawaida, au jeraha kwa neva zinazodhibiti kuoga. Ugonjwa wa Vesicoureteral Reflux Hupimwaje? Nyakati nyingine, madaktari hupata ugonjwa huo kabla ya mtoto kuzaliwa wakati wa uchunguzi wa kawaida wa sauti kabla ya kuzaliwa. Utafiti huo unaweza kuonyesha kwamba mtoto ana hydronephrosis (kupanuka kwa njia ya mkojo) ambayo ni uvimbe wa figo na mkojo (mfumo ambao hutiririka figo kwenye kibofu). Ikiwa mtoto wako ana dalili za UTI, mwone daktari mara moja. Daktari atafanya uchunguzi, atauliza kuhusu historia ya afya ya familia yako, na huenda akaagiza uchunguzi. Uchunguzi wa damu na mkojo unaweza kuona jinsi figo zinavyofanya kazi vizuri na kuangalia dalili za maambukizo au uharibifu wa figo. - Uchunguzi wa ultrasound ya tumbo hutumia mawimbi ya sauti kuunda picha za njia za mkojo. Hizi zaweza kuonyesha dalili za maambukizo, uvimbe wa figo, au kibofu cha mkojo kilicho nene. Cystourethrography (VCU) ni mtihani wa kawaida wa kukagua mgonjwa. Mtaalamu hujaza kibofu cha mkojo na kioevu maalum, kisha huchukua picha za X-ray wakati kibofu cha mkojo kinapojaza na kutolewa wakati wa kukojoa. Usonografia ya Uro ya Uro ya Uro ya Uro (CEVUS) Kama ilivyo na VCU, catheter huwekwa na kibofu cha mkojo hujazwa na kioevu maalum. Lakini ultrasound hutumiwa badala ya X-ray ili kupata picha. Jaribio hili halitumii mnururisho. Kwa mfano, kama mtoto ana VUR, daktari anaweza kumpa kiwango cha juu kutoka I hadi V. Refluks ya daraja la kwanza ni laini zaidi, na mkojo unarudi nyuma hadi kwenye ureters. Reflux ya daraja la tano ndiyo mbaya zaidi. Ugonjwa wa Vesicoureteral Reflux Unatibiwaje? Watoto wenye VUR ya kiasi kidogo mara nyingi hawahitaji matibabu. Watoto wengi wenye VUR ya msingi huikimbia. Kadiri mtoto anavyoendelea kukua, mkojo wake unakuwa mrefu na wa moja kwa moja, na baada ya muda utaendelea kukua vizuri. Madaktari hutumia dawa za kuua viini kutibu VUR ambayo hutokea na UTI. Hilo huzuia maambukizo yasisambee kwenye figo. Watoto wanaotumia dawa za kuua viini wanapaswa kuzitumia kwa muda mrefu kama ilivyoelezwa, hata ikiwa wanaanza kujisikia vizuri. Watoto wengine huchukua viuavijasumu kila siku ili kuzuia maambukizo ya mfumo wa mkojo. Daktari anaweza kukusaidia kufanya upasuaji wa kuondoa VUR. Aina ya upasuaji unaopatikana kwa ukawaida zaidi ni upasuaji wa kuingiza damu ndani ya mkojo. Katika utaratibu huu, daktari-mpasuaji huingiza ureter moja au zote mbili ndani ya kibofu cha mkojo. Hii huzuia mkojo kutiririka nyuma kutoka kwenye kibofu cha mkojo hadi kwenye mkojo na figo. Watoto ambao hupitia upasuaji huu kwa kawaida hutumia siku 1 hadi 2 hospitalini wakati wanapojipona. Upasuaji huu hufanywa kupitia ufunguo chini ya mstari wa nguo za ndani au kwa njia ya roboti kupitia vipande vidogo kwenye tumbo. Upasuaji mwingine, sindano ya endoscopic, huhusisha kuingiza gel ya pekee ndani ya kibofu cha mkojo kupitia bomba nyembamba. Daktari-mpasuaji huweka gel hiyo ndani ya mlango wa mkojo. Hii huzuia mkojo kutoka kurudi ndani ya mkojo na husaidia mkojo kufungwa vizuri. Watoto wengi ambao wanafanyiwa upasuaji huu wanaweza kuondoka hospitalini siku hiyohiyo. Watoto walio na VUR ya sekondari wanaweza kupata kupambana na maambukizi na matibabu kwa tatizo kuu ambalo lilisababisha VUR. Ni Nini Zaidi Ninapaswa Kujua? VUR isiyotibiwa inaweza kusababisha matatizo ya muda mrefu. Ugonjwa wa figo unaweza kusababisha upungufu wa damu, shinikizo la damu la juu, protini katika mkojo, matatizo ya figo au kushindwa kwa figo, na unaweza kusababisha dalili za ugonjwa wa mkojo. Matibabu ya haraka ya VUR yanaweza kuzuia matatizo ya muda mrefu na uharibifu wa figo. Ugonjwa wa Urinary (UTI) na Hali zinazohusiana Ultrasound: Kidney (Kidonda, Ureters, Kibofu cha Mkojo) - Uchunguzi wa Mkojo - Urinary Infections (UTI) - Ultrasound: Tumbo - Voiding Cystourethrogram (UGVC) Kumbuka: Habari zote ni kwa madhumuni ya elimu tu. Kwa ushauri maalum wa kitiba, utambuzi, na matibabu, wasiliana na daktari wako. 1995 - Msingi wa Nemours. KidsHealth® ni alama ya biashara iliyosajiliwa ya The Nemours Foundation. Haki zote zimehifadhiwa. Picha zinazotokana na The Nemours Foundation na Getty Images.