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Vesicoureteral reflux

What is vesicoureteral reflux?

When the urinary tract is functioning properly, urine flows from the kidneys down the ureters into the bladder. Vesicoureteral reflux is diagnosed when urine flows in reverse: from the bladder back toward the kidneys. Left untreated, this retrograde flow can trigger urinary tract infections and possibly cause kidney damage. Vesicoureteral reflux affects persons of all ages, but is most commonly found among children.

What causes vesicoureteral reflux?

This condition is diagnosed as being either primary or secondary vesicoureteral reflux.

Primary vesicoureteral reflux occurs when the valve between the ureter and the bladder is not working properly. The purpose of this valve is to keep urine flowing in one direction – downward from the ureter into the bladder. When the valve malfunctions, urine may flow backward. Typically this is a congenital defect that can affect one or both ureters. Along with being a birth defect, this condition can be inherited.

Secondary vesicoureteral reflux is diagnosed when an abnormality occurs in the urinary tract. This can include a blockage, functional problems that keep the bladder from emptying properly (muscle or nerve damage/spinal cord problems), and high bladder pressure (sometimes caused by bladder infections/inflammation).

How is this diagnosed?

There are several tests that can be used to diagnose vesicoureteral reflux. Tests can also be performed to check the condition and functioning of urinary organs as well as the patient’s blood and urine.

  • Voiding cystourethogram – When this test is performed, a very thin tube is used to inject dye into the bladder. During the test, the patient is asked to urinate while X-ray imaging is used to capture urine flow. The goal of the test is to identify if urine is flowing up the ureters toward the kidneys.
  • Radionuclide cystogram – This test is much like the voiding cystourethogram, however, a radioactive material is injected into the bladder and a nuclear scan is used for imaging.
  • Urodynamics testing
  • Abdominal ultrasound
  • Blood and urine tests

Testing allows the provider to make an accurate diagnosis and determine the best treatment option. Treatment may include an endoscopic injection, medication, or surgery. If the reflux has caused a urinary tract infection, the patient will be prescribed antibiotics. Testing also allows the provider to ‘grade’ the reflux based on a commonly used system of five reflux grades. These grades range from minimal affect (Grade 1)  to severe damage (Grade 5).

If you’re experiencing symptoms that may be linked to a urinary tract infection, or if you have trouble voiding, contact Urology Austin to schedule an appointment with one of our providers.