Question Title: Antibiotics only treatment for reflux?

Dear Lisa,
The usual routine for treatment of newly diagnosed urinary reflux is long term prophylactic antibiotics.
There is a good chance that a grade 2 or 3 reflux would resolve over time without any need for corrective surgery. The patient, however, needs to be on antibiotics to prevent infection, since this( infection) could cause renal scarring, which in turn contributes to deterioration of renal function. Frequent urinalysis is not an optimal and safe way of detection of infection, which if missed for even a few days, could cause long term problems. As the child grows and follow-up evaluation reveals the resolution of reflux, it is possible to stop the antibiotics and hope that no more infections would result. If the patient develops breakthrough urinary infection while on antibiotics, or after antibiotics were discontinued, surgical repair may have to be considered. The option of restarting a different antibiotic is also a possibility.
As far as the long term effects of antibiotics, it is possible to develop: 1) resistant bacteria, 2) sesitivity and allergy to the antibiotic or3)have side effects from the antibiotic. These can be taken care of by switching to a different antibiotic. Otherwise, there should be no major concerns for taking long term antibiotics.
The alternative to prophylactic antibiotics would be corrective surgery, which has its own indications and set of risks.
It is the more conservative and prudent route to consider antibiotics as the starting course of action.

This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its urban campuses by calling (1 800 653 6568).

Sincerely;
HFHS-M.D. BE
* Keyword: vesicoureteral reflux

As a sufferer of Vesico-Ureteral Reflux, I've been on alot of antibotics. I am 25 year old female. For 5 years now, I get pyelophritis, usually once a month. I have taken Macrodantin for 3 years straight - now, I'm resistant. I'm allergic to Cipro, and Sulfa drugs. Keflex, I just finished a 10 day treatment, and I still have the infection. I am now on IV at home, with Gentamicin. I am praying this works, as I don't know where or what I am gonna do if this doesn't work.

I have reflux due to a complication in the surgery to remove Endometrisois. My right ureter was cauterized, and had to be re-implanted into the bladder. I've been told that reflux corrects itself - but its beeen 5 years. How much more infections do I have to go through before it starts to correct itself? And how does that valve grow back??

Thank you for your time! ;-)

Dear Christine,
It appears that you have a very frustrating problem. From the history that you have given, the most likely problem is that the right side continues to have reflux .. Given the length of time since your surgery, it is unlikely that the reflux would resolve. With this history of recurrent pyelonephritis and chronic antibiotics, I think it is appropriate for you to have a repeat evaluation by a urologist for a possible repeat procedure to relieve the reflux.

As far the “valve”, I suspect that you are talking about the valve mechanism at the opening of the ureter to the bladder. This is not exactly a valve, but a mechanism that acts like a valve. It has to do with the ratio of the length of the ureter that is reimplanted within the bladder muscle, to the diameter of the ureter. A ratio of 5 to 1 imparts a valve like function to this reimplanted system.

This information is provided for general medical education purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its urban campuses by calling (1 800 653 6568).

Sincerely;
HFHS-M.D. BE
* Keyword:urinary reflux