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Urology (Expert Forum)
vesicoureteral reflux
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
Boston - MA
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
vesicoureteral reflux
by 151, May 08, 2006 12:00AM
I am a 30 year old male that was recently diagnosed with having an atrophic small kidney on one side and scarring on the other kidney. During recent tests doctors were able to determine that there had been a reflux on the side with the atrophic kidney. On the other side, they were unable to determine a reflux as no voiding cystourethrogram was performed.
Initial symptoms that prompted me to see a physician were foamy urine which subsequently revealed high levels of protein. In addition, I have other symptoms as well. These include a difficulty to initiate urine flow, a weak stream as well as dribbling after urination. Overall, I am experiencing hesistancy since a about 4-5 years. My doctor hasn't seen the link between vesicoureteral reflux and the urination problems. He has recommended me to void on a regular schedule every two hours. This hasn't improved the situation though. On the contrary, in cases where I had more fluid intake than usual I then started having even more problems emptying the bladder. I have since resumed normal habits, making sure, however, that I don't keep it too long.
Recently, I have come across literature that describes hesitancy, weak stream, etc. as symptoms of a vesicoureteral reflux. My questions are the following: how strong is the link between these symptoms and vesicoureteral reflux? is it possible that my difficulties to pass urine (which vary) are directly linked to vesicoureteral reflux? if this is the case, shouldn't the reflux on the side with the atrophic kidney be treated (even if the kidney is no longer functioning)? is it possible that i have had reflux on and off since childhood? Do you know of similar cases where patients with vesicoureteral reflux have difficulties voiding? What is the best way to address these problems? i also have gout, is this in any way linke to the above?
Thank you for your valuable feedback!
Initial symptoms that prompted me to see a physician were foamy urine which subsequently revealed high levels of protein. In addition, I have other symptoms as well. These include a difficulty to initiate urine flow, a weak stream as well as dribbling after urination. Overall, I am experiencing hesistancy since a about 4-5 years. My doctor hasn't seen the link between vesicoureteral reflux and the urination problems. He has recommended me to void on a regular schedule every two hours. This hasn't improved the situation though. On the contrary, in cases where I had more fluid intake than usual I then started having even more problems emptying the bladder. I have since resumed normal habits, making sure, however, that I don't keep it too long.
Recently, I have come across literature that describes hesitancy, weak stream, etc. as symptoms of a vesicoureteral reflux. My questions are the following: how strong is the link between these symptoms and vesicoureteral reflux? is it possible that my difficulties to pass urine (which vary) are directly linked to vesicoureteral reflux? if this is the case, shouldn't the reflux on the side with the atrophic kidney be treated (even if the kidney is no longer functioning)? is it possible that i have had reflux on and off since childhood? Do you know of similar cases where patients with vesicoureteral reflux have difficulties voiding? What is the best way to address these problems? i also have gout, is this in any way linke to the above?
Thank you for your valuable feedback!
Doctor's Answer
by Kevin Pho, MD, May 09, 2006 12:00AM
, May 09, 2006 12:00AM
Vesicoureteral reflux is more common during childhood. If this continues to be a concern, or is suspected, a VCUG needs to be performed.
There can be other causes for your symptoms. Proteinuria is indicative of a variety of kidney diseases. A referral to a nephrologist can work this up, possibly including a kidney biopsy.
Difficulty passing urine can also suggest a lower GU disorder - including a urethral stricture or polyp. An enlarged prostate can also be present. These options can be discussed with a urologist.
These options can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_
There can be other causes for your symptoms. Proteinuria is indicative of a variety of kidney diseases. A referral to a nephrologist can work this up, possibly including a kidney biopsy.
Difficulty passing urine can also suggest a lower GU disorder - including a urethral stricture or polyp. An enlarged prostate can also be present. These options can be discussed with a urologist.
These options can be discussed with your personal physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_
