Cystic-mochetochnykovыy reflux in Adults – PMR

Vesicoureteral Reflux—Adult (HIT; Reflux Nephropathy; Chronic Atrophic Pyelonephritis; Vesico-Ureteric Reflux; Ureteral Reflux)

Description TMR adults

Cystic-reflux mochetochnykovыy (PMR) – a reverse flow of urine. Wherein 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 you have this disease, consult a physician immediately.

The causes of VUR in adults

This disease can cause the following problems:

• The problem at the junction of the ureter and bladder;
• Ureter enters far enough into the bladder;
• Bladder neck obstruction (eg, blocking the flow of urine due to an enlarged prostate);
• Neurogenic bladder (loss of normal bladder function due to damaged nerves, control the operation of the bladder);
• Temporary swelling after kidney transplant.

Risk factors for PMR in adults

Factors, that may increase the risk of adult PMR include:

• Family history;
• Congenital abnormalities of the urinary tract;
• Birth defects, which affect the spinal cord, such as spina bifida;
• Tumors of the spinal cord or pelvis;
• Spinal Cord Injury.

Symptoms of VUR in adults

In most cases, the TMR has no obvious signs or symptoms. In some cases, the TMR detected after 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.

Prenatal ultrasound may show swelling of the kidney. This condition is called hydronephrosis and may indicate the presence of PMR.

Diagnosis of VUR in adults

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

Tests may include:

• Blood tests;
• Urine;
• US;
• CT scan;
• 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.

In rare cases,, a sign of kidney damage can be high blood pressure.

Treatment of VUR in adults

The aim of the treatment is to prevent MTCT irreversible renal damage. Treatment options include the following:

The operation for the treatment of VUR in adults

Endoscopic injection into the ureter

This procedure – minimally invasive surgery, performed to cure reflux. The place, wherein ureter enters the bladder, introduced a special gel, prevents the return of urine into the ureter. This procedure is performed through a small tube, called a cystoscope.

Ureteral reimplantation

The operation allows for repositioning the ureters in the bladder. It can be done 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.

Prevention of MTCT in adults

PMR can not be prevented in most cases. However, further complications of the disease can be prevented by immediate treatment of bladder or kidney infections. This is particularly important, if you have a neurogenic bladder.