Does your little one get frequent urinary tract infections? Does this condition sometimes come with a fever? Many parents are worried about this. One of the main reasons for this could be the condition we are talking about today, Vesicoureteral Reflux, or VUR for short. Don't be scared when you hear this name, this is a treatable condition that often occurs in young children. Let's talk about it simply.
Simply put, what is VUR?
Think of the kidneys in our body as two water filters. They filter out the unwanted waste products from our blood and excrete them as urine. The urine that is produced flows down two thin tubes called ureters and collects in the bladder . It's like filling a tank with water. When the tank is full, we feel the need to urinate, and we urinate and expel it. This is the normal process.
However, in someone with VUR, the opposite happens. That is, urine that has accumulated in the bladder flows back up, that is, along the ureter, towards the kidneys. It is like a river that should be going downhill but has to go up. When urine flows back up this way, it can also carry germs, such as bacteria, to the kidneys. This is the main cause of frequent urinary tract infections (UTIs) and kidney damage.
What causes VUR?
VUR can occur in two main ways.
1. Primary VUR
This is the most common. Most of the time, this is due to a small problem that is present at birth . Where our urethra (ureter) connects to the bladder, there is a small valve-like flap. Its job is to allow urine to go only one way, that is, into the bladder. It does not let it come back up. It is like a door that only opens one way. However, in some children, this valve is born a little short and may not close properly. Then, when the bladder fills or when you urinate, the urine goes back up.
2. Secondary VUR
This is caused by a blockage in the bladder or other parts of the urinary tract. For example, if the bladder's nerve function is impaired or if there is another blockage, the pressure inside the bladder increases, pushing the urine back up.
What are the symptoms of this condition?
Many children with VUR do not have any outward symptoms. However, if symptoms do occur, they are often a sign of a urinary tract infection (UTI). Check to see if your child has any of these symptoms.
| Characteristics category | Commonly seen symptoms |
|---|---|
| Symptoms of a urinary tract infection (UTI) that often appear first | |
| Fever | Especially a fever that comes on without any other obvious reason. |
| Pain during urination | Burning or pain when urinating, the baby crying. |
| Changes in urine | Blood in the urine, dark color, or a strong odor. |
| Frequent urination | Urgent need to urinate, but only a little at a time. Wetting clothes. |
| Stomach pain | Lower abdominal pain. |
| Other symptoms that may be related to VUR | |
| Not gaining weight | Loss of appetite and poor weight gain in the child. |
| High blood pressure | High blood pressure. |
| Constipation | Difficulty defecating and inability to control it. |
Most importantly: If your child shows any of these signs of a urinary tract infection (UTI) , see a doctor immediately . Don't ignore it, especially if your child has a fever.
How exactly is this disease diagnosed?
VUR can sometimes be detected during an ultrasound scan before the baby is born. Otherwise, your doctor may recommend one or more of these tests based on your symptoms.
- Voiding Cystourethrogram (VCUG): This is the main test used to diagnose VUR. In this test, a small tube is inserted into the bladder and a special dye is injected into the bladder. Then, a video X-ray is taken as the child urinates to see if the dye flows back into the kidneys. This test can be a bit uncomfortable for children, so it is done with medication to keep the child calm, if necessary.
- Abdominal Ultrasound: This is a painless scan. It can check the condition of the kidneys and whether they are damaged or scarred.
- Blood test and urine test: A blood test can give an idea of how well your kidneys are working. A urine test can confirm whether you have an infection.
What are the treatments?
After the tests, the doctor will give the VUR a "grade" (e.g., 1 to 5) based on the severity of the condition. The higher the number, the more severe the condition. Treatment is determined based on this grade, the child's age, and the symptoms.
The good news is that in most children, low-grade VUR gets better on its own as the child gets older. This is because the valve between the urethra and the bladder lengthens and starts to function properly.
The following are used as treatments:
- Antibiotics: These are given to prevent and treat urinary tract infections (UTIs). This is very important to stop the infection from spreading to the kidneys. It is essential to take the medication for the full duration prescribed by the doctor.
- Deflux injection: This is not surgery. A gel-like liquid is injected into the bladder using a special device, which is inserted into the urethra where it connects to the urethra. This causes a small swelling there, and the valve starts to close tightly. This stops urine from flowing back up.
- Surgery: This is only done in very severe cases, when medication cannot control the condition, or when there is ongoing damage to the kidneys. Surgery permanently corrects the problem with the valve.
Things you can do at home as a parent
If you have a child with VUR, it is very important to take care of these things.
- Teach your child to go to the toilet at regular intervals, every two to three hours . Don't let him hold his urine for too long.
- Give the antibiotics prescribed by the doctor exactly as prescribed, even if they are given to prevent infection. Don't stop taking them halfway just because your child is feeling better.
- Make sure your child drinks plenty of water . This will help wash away bacteria.
- Reduce your intake of sugary drinks and sodas, as they can irritate the bladder.
- If you have stomach pain or discomfort, place a hot water bottle or a heated cloth on your stomach and rub it. It will provide relief.
By understanding this condition and working with your doctor, you can protect your child's kidneys and help them live a healthy life.
Take-Home Message
- Vesicoureteral reflux (VUR) is the backflow of urine from the bladder to the kidneys. It is common in young children.
- The main and most common symptom of this condition is a urinary tract infection (UTI) accompanied by fever.
- If your child shows signs of a urinary tract infection, especially if they have a fever, seek medical advice immediately.
- Most children outgrow this condition as they grow older, but treatment options depend on the severity of the condition.
- It is very important to take antibiotics prescribed by your doctor for the full duration.
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