Vesicoureteral reflux is the abnormal flow of urine, called retrograde reflux, in which urine present in the bladder returns to the ureter to the kidney, and normally does not cause symptoms, being identified through tests to investigate the cause of urinary infections, since that vesicoureteral reflux increases the risk of developing urinary infections.
This change is mainly identified in children who have very frequent urinary infections, and is generally considered a congenital change, that is, one that appears from birth, due to a defect in the valve at the ureterovesical junction, which has the function of preventing urine from leaving the bladder rise to the kidney.
The treatment of vesicoureteral reflux is carried out by a urologist or pediatrician, and must be started as soon as possible to avoid damage to the kidneys, and the use of antibiotics and/or surgery may be indicated, depending on the degree of the change.
Vesicoureteral reflux symptoms
The main symptoms of vesicoureteral reflux are:
- Urge to urinate all the time;
- Burning sensation or pain when urinating;
- Feeling of heaviness in the bladder;
- Urinate with little quantity;
- Urinal safety;
- Pain in the lower back;
- Fever.
These symptoms are generally related to urinary infection caused by vesicoureteral reflux, and therefore, this condition is usually identified in tests to investigate the cause of the urinary infection. Know how to identify all the symptoms of a urinary tract infection.
How to confirm the diagnosis
Vesicoureteral reflux can be suspected by a pediatrician or urologist, based on the presence of symptoms and a history of frequent urinary infections, especially in children.
To confirm the diagnosis of vesicoureteral reflux, the doctor must request tests that evaluate the functioning of the urinary system and changes in the anatomy of the bladder and/or urethra, such as urinalysis, ultrasound of the kidneys, ureters and bladder, or voiding cystourethrography. Find out how voiding cystourethrography is performed.
The voiding cystourethrography exam, in addition to confirming the diagnosis, is capable of determining the degree of vesicoureteral reflux.
Possible causes
Vesicoureteral reflux is caused, in most cases, due to a defect in the valve at the ureterovesical junction, which prevents urine from returning to the ureter after reaching the bladder, which happens during the child’s development during pregnancy and, therefore, This is considered a congenital change.
However, this situation can also occur due to bladder malfunction, obstruction of urinary flow, damage to the bladder muscle or the nerves that control bladder emptying.
Degrees of vesicoureteral reflux
According to the characteristics observed during the examination and the symptoms presented, the doctor can classify vesicoureteral reflux into degrees, namely:
- Grade I: urine returns only to the ureter and is therefore considered the mildest degree;
- Grade II: urine returns to the kidney;
- Grade III: there is a return of urine to the kidney and there is dilation in the organ;
- Grade IV: there is a greater return of urine to the kidney and dilation of the organ, and signs of loss of function may also be seen;
- Grade V: return of urine to the kidney that results in great dilation and changes in the ureter, being considered the most serious degree of vesicoureteral reflux.
Depending on the degree of reflux, signs and symptoms presented and the person’s age, the doctor can recommend the best type of treatment.
How the treatment is carried out
The treatment of vesicoureteral reflux must be carried out according to the recommendation of the urologist or pediatrician and may vary according to the degree of reflux. Thus, in grade I to III reflux, the use of antibiotics is common, as this makes it possible to reduce symptoms related to bacterial infection, promoting symptom relief. Especially because when it occurs in children under 5 years of age, spontaneous healing is common.
However, in the case of grade IV and V reflux, surgery is normally recommended with the aim of promoting improved kidney function and reducing the return of urine. Furthermore, surgical treatment may also be indicated for people who did not respond well to antibiotic treatment or who continued to have recurrent urinary infections.
It is also important that all people diagnosed with vesicoureteral reflux are regularly monitored by a doctor, as this allows kidney function to be monitored, promoting its proper functioning.
