Re: Vesicoureteral Reflux

Posted By HFHS M.D.-JL on March 17, 1999 at 06:28:15:

In Reply to: Vesicoureteral Reflux posted by Lori on March 11, 1999 at 15:46:11:






I was diagnosed with a vesicoureteral reflux at the age 2 and a half.  I had a grade four and have severe scarring on my right kidney.  My 3 anmd a half old daughter has her first Urinalysis which shows blood in her urine.  Her doctor is concerned about her developing my reflux and has sceduled a follow-up urinalyisis for next week.  If that has positive results we will go for the rest of the testing.  My question is, can she be "developing" reflux ( in other words is this genetic)?  I also have a 12 month old son, should we be looking at him too if it is genetic whether or not my daughter has it?  Please help me with this, I am frightened because of my past history and experience.  




Dear Lori,
Primary Vesicoureteral reflux (VUR) --urine traveling from the bladder to the kidney-- is a congenital anomaly due to malfunction of the ureteral valves that prevent  backflow of urine.  VUR occurs in about 18.5% of children.  It is more common in white female patients which are fair-skinned with blue eyes and blond/red hair.  Siblings of patients also have an increased risk of having VUR.  Hydronephrosis on ultrasound and reflux on VCUG confirm the diagnosis.  The treatment consist of prophylactic antibiotics to prevent infection of urine (UTI) with serial urine cultures and renal imaging.  The younger the child is at diagnosis of VUR, the more likely it will resolve without surgery.
Secondary VUR may be the result of several causes of bladder outlet obstruction.  Yes, VUR can develop, but it this instance, it was probably a developmental abnormality present at birth.  If she does have VUR then from a urological stand point, she should be on antibiotics and have serial urine culture and sensitivities to screen for UTI.  If she has a UTI on antibiotics (a breakthru UTI), failure of renal growth on serial ultrasounds,  renal scarring, deterioration of renal function,  or if the reflux persists into puberty, then she should undergo surgery consisting of ureteral reimplantation.  The results of the surgery are excellent >90-98% success rate.
You can use this one:  More individualized care is available at the Henry Ford Hospital and its urban campuses by calling  (1 800 653 6568). We can also arrange local accommodations through this number if this is your need. Please bring any physicians' notes and lab test results that you  may be able to obtain. These will help us greatly.
Sincerely,
HFHS M.D.-JL
*keyword: vesicoureteral reflux