Vesicoureteral reflux (VUR), commonly known as urinary reflux, is the abnormal backwards flow of urine from the bladder toward the kidneys. Urinary reflux is most commonly diagnosed in babies and children, and if left untreated it can lead to kidney damage caused by urinary tract infections that involve the kidneys. Learn to spot urinary infections and VUR so you can get your child treatment.
Looking For Symptoms
1. Watch for symptoms of urinary tract infections (UTIs). UTIs are a common sign of urinary reflux, so if your child has one or several UTIs, you should consider having him tested for VUR.
2. Identify any kidney pain in older children. Older kids with urinary reflux (as well as other UTIs) may also experience kidney pain. Kidney pain is felt as a pain on either side of the back, just beneath the lower ribs.
3. Look for dysfunctional urination. Dysfunctional urination is a symptom of more serious urinary reflux. This can be an overactive bladder, a tendency to "hold in" urine, or the inability to release anything but a very weak stream of urine (particularly in boys). Your child may also be suffering from severe constipation (holding in stool).
4. Look for other symptoms of bladder/bowel dysfunction (BBD). These may include having to urinate often or suddenly, long periods of time between bathroom visits, daytime wetting, and posturing to prevent wetting. Your child may also have pain in the penis or perineum (the area between the anus and genitals), constipation (fewer than two bowel movements in a week, and painful, large, or hard when they happen), bedwetting, or incontinence (the inability to hold stool in the colon and rectum).
5. Be aware of birth defects. One type of VUR is caused by an obstruction in the bladder. In some cases this is the result of surgery or injury. It is also common in children with spinal cord birth defects like spina bifida.
6. Check your family history for the presence of urinary reflux. VUR can be a genetic disease, so if the parents had it in the past, their children could develop it. If the mother had VUR in the past, as many as half of her children could have VUR. Similarly, if one child has it, their siblings might, especially younger siblings. About 32% of siblings will develop the disease, and nearly 100% of identical twins.
Receiving a Medical Diagnosis
1. Make an appointment with a doctor. If you suspect VUR, or just have evidence for a UTI, you will want to go to a doctor to get a diagnostic test and the best treatment options.
2. Do a sonogram study of the kidneys and bladder. A sonogram uses very high frequency sound (ultrasound) to generate images, which avoids radiation exposure.
3. Have a catheter inserted for a bladder reflux test. The two most common and reliable tests for reflux require using a catheter, a thin flexible tube the doctor inserts into the bladder.
4. Do a voiding cystourethrogram (VCUG). After the bladder catheter has been inserted, you doctor may choose to test for the presence of urinary reflux using a VCUG.
5. Use a radionuclide cystogram (RNC). Alternatively, your doctor may choose to do test for the presence of urinary reflux using an RNC.
6. Decide on a treatment. Opinions vary on the best ways to treat VUR. These will depend on your individual child, and how much he or she is suffering.