Causes and risk factors
It is seen in children usually. It presents as a birth defect. Normally, urine flows from kidneys into the ureters and then to the bladder. There is a one way flap between ureters and bladder which prevents backflow of urine from bladder to ureters. Vesico uretric reflux is seen as a birth defect in children. In this, there is an abnormal attachment of bladder and ureter with an infective flap valve. This causes backflow of blood from bladder to ureters and back to kidneys. This causes bacterial entry from bladder to kidneys causing infection and inflammation. Infrequent urination can cause VUR in some children. Vesico uretric reflux can be caused due to chronic pyelonephritis, abnormal ureters, bladder infections [cystitis], bladder outlet obstruction, bladder stones, neurogenic bladder, irradiation to the bladder, surgery involving the bladder or ureters.
Clinical presentation
Vesico uretric reflux can be asymptomatic or produce following symptoms like blood in the urine [haematuria,] burning while urination, dark or foamy urine, feeling of incomplete urination, frequent urination at night, urine urgency. Accompanied symptoms include pain in abdomen, flank or back. Other symptoms that can occur with this disease include fever with chills, nausea, vomitting, urinary hesitancy, reduced appetite, increased blood pressure.
Investigation
Medical history by the patient and Clinical examination by the doctor helps in diagnosis. Test include Kidney function test, urine analysis for infection, blood or protein in urine is done. Imaging studies such as pelvic ultrasound, micturating cystography is diagnostic of the vesico uretric reflux.
Treatment
Treatment depends upon the underlying cause. Bladder training and making the patient empty the bladder completely is required. Treatment for vesico uretric reflux consists of prophylactic antibiotics for the infection, anti hypertensive medications for managing high blood pressure. Surgery is required in severe cases.
Other Modes of treatment
The other modes of treatment can also be effective in treating Vesico uretric reflux. Homoeopathy is a science which deals with individualization considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly the ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating vesico uretric reflux.
