Cystic-mochetochnykovыy reflux in children – PMR – Vezykouretralnыy reflux in children

Vesicoureteral Reflux—Child (VUR—Child; Reflux Nephropathy—Child; Chronic Atrophic Pyelonephritis—Child; Vesico-Ureteric Reflux—Child; Ureteral Reflux—Child)

Description of vesicoureteral reflux in children

Cystic-reflux mochetochnykovыy (PMR) – reverse flow of urine from the bladder into the kidney back.

The urine from the kidneys through the ducts, called ureters, into the bladder. Each ureter joins the bladder so, to prevent leakage of urine back into the ureter. The connection of the ureter to the bladder like a one-way valve. When the ureter is not working properly, urine can leak back to the kidney. If the urine contains bacteria, the kidney may be infected. Urine can also put additional pressure on the kidneys, which may cause damage to.

PMR potentially serious disease, which requires a doctor's care. Early treatment and prevention of infections give good results. If you suspect, that your child has this disease, consult a physician immediately.

The causes of VUR in children

This disease can cause the following problems:

• The problem at the junction of the ureter and bladder;
• Ureter enters far enough into the bladder;
• Neurogenic bladder (loss of normal bladder function due to damaged nerves, control the operation of the bladder).

Risk factors for PMR children

Factors, that may increase the risk of TMR in children include:

• Family history (especially, if a brother, sister or a parent are the PMR);
• Birth defects of the urinary tract;
• Birth defects, which affect the spinal cord, such as spina bifida;
• Tumors of the spinal cord or pelvis.

Symptoms of VUR in children

In most cases, the child PMR no evident symptoms or signs. In some cases, the TMR detected after diagnosis of infection of the urinary tract or kidneys. Symptoms of urinary tract infection include:

• Frequent and urgent need to urinate;
• A small amount of urine;
• Pain in the abdomen or pelvis;
• Burning sensation while urinating;
• Turbid, bad-smelling urine;
• Increased need to get up, to urinate, at night;
• Blood in the urine;
• The flow of urine;
• Back pain or pain along the side edges;
• Fever and chills.

Diagnosis of VUR in children

The doctor will ask about your symptoms and medical history, and perform a physical examination.

Tests may include:

• Blood tests – to evaluate, how well the kidneys are functioning;
• Urine – to find evidence of infection or kidney damage;
• US – test, which uses sound waves to study the kidneys and bladder;
• CT scan – X-ray views, wherein the computer is used, to make pictures of structures inside the body;
• Cistouretrografiâ – into the bladder through a catheter inserted liquid, which can be seen on x-ray. X-rays performed after filling the bladder, and when urinating;
• Intravenous pyelogram – fluid, which can be seen on x-rays is injected into a vein. X-ray performed after, as the radiopaque fluid from the blood is in the kidney and bladder;
• Nuclear scanning – It includes a variety of tests using radioactive materials, are introduced into a vein or bladder, to see, how well the urinary system.

The doctor will evaluate the child's condition on a scale ranging from 1 (mild) to 5 (severe degree).

Treatment of VUR in children

The goal in treating PMR in children is to prevent irreversible damage to the kidneys. Treatment options include the following:

Monitoring

If the child is estimated in the range 1-3 POINTS, it, perhaps, It does not need urgent treatment. PMR can disappear by itself, As the ureters. The doctor will monitor the condition of the child. Treatment may include:

• Prophylactic antibiotics – child, perhaps, will have to take a low dose of antibiotic every day, to prevent infection.
• Tests to check kidney function.

Children are encouraged to drink plenty of fluids and urinate frequently.

Surgery for VUR in children

In most cases the operation is not necessary. If your child does need surgery, The following options will be considered:

• Ureteral reimplantation – operation can be performed in two ways. One method requires incision above the pubic bone and repositioning the ureters in the bladder. Also reimplantation can be done laparoscopically, by introducing chamber through small incisions in the abdomen and / or bladder;
• Endoscopic injection into the ureter – minimally invasive surgery, performed to eliminate reflux. The place, wherein ureter enters the bladder, introduced a special gel, prevents the return of urine into the ureter.

Prevention VUR in children

PMR in most cases can not be prevented. However, further complications of the disease can be prevented by immediate treatment of bladder or kidney infections.