VUR

When I was four a had surgery to correct my VUR. Now I'm 20 years old and I have an eight year old sister who has wet the bed consistantly (basically nightly) since she's been potty trained. From what I've noticed, she also urinates frequently. At this point, my step-mom is worried about my sister and wonders if there could be something wrong with her.
I'm in school right now to be a physician assistant and I've learned that VUR seems to be somewhat genetic, occuring more often in families.
Is it possible my sister might have VUR and should get tested?
What are the chances my eight month old sister could also inherit this?
Thanks.

[Stephen Liroff, MD]

Good questions!
There is about a 30% chance that the sibling of a refluxing patient also has reflux. I would recommend that your sibs have a urinalyses and renal ultrasounds. If both are normal, then I would stop there (assuming no urinary tract infections). Some pediatric urologists recommend having formal voiding cystourethrograms (NOT nuclear cystograms as they do not give any anatomical information), but I think that in the absence of infections and having normal kidneys, there would not be an indication to treat. The eight month old is a bit more at risk if she has reflux, even if she has not demonstrated any UTI's. I would just  follow her with frequent urine cultures.
As regards the nocturnal enuresis, from a social/psychological standpoint she probably benefit from treatment. She'll probably do well with an anticholinergic such as ditropan. A pediatric urologist if not her pediatrician should be able to handle this.
S.A.Liroff, M.D.