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Urology (Expert Forum)
urinary reflux
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
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.
urinary reflux
by suek, Jul 10, 2004 12:00AM
My daughter is 3 years old. Last year she had her first UTI and was hospitalized and then diagnosed with urinary relux. She is grade 2 on one side, grade 2 on the other. She has been taking an antibiotic everyday since then. Recently she has had 2 UTIs in the passed 3 months. Why all of a sudden is the preventative antibiotic not working? Does this mean she will need surgery? What does the surgery intale?
My 5 year old son also has urinary rlux. He has never had a UTI (we know he has it because he had to be tested because of my daughter's diagnoses.) He takes the antibiotic every other day. Is this really necessay if he's never had a UTI?
My 5 year old son also has urinary rlux. He has never had a UTI (we know he has it because he had to be tested because of my daughter's diagnoses.) He takes the antibiotic every other day. Is this really necessay if he's never had a UTI?
Doctor's Answer
by Kevin Pho, MD, Jul 10, 2004 12:00AM
, Jul 10, 2004 12:00AM
Both medical and surgical management of severe reflux appear to be of roughly equal efficacy and choosing between these options is dependent upon clinical judgment. Medical therapy in such children includes daily prophylactic antibiotics which are usually continued until the reflux resolves (as determined from annual radionuclide cystography) the child reaches the age of five to seven, the time at which repeat infection, if it occurs, is unlikely to produce new scars.
Surgical correction of reflux should be individualized and is probably indicated in the following settings:
* The presence of gross reflux and ureteral dilatation in a young child (particularly if under two years of age) even without marked scarring, since new scars will develop in up to 60 percent of these cases.
* A child who becomes infected and shows new scars because of incomplete compliance with medical therapy.
* A family that elects surgery, because compliance with daily antimicrobial therapy is too difficult to achieve or adequate follow-up is difficult for geographic reasons.
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.
Medical Weblog:
kevinmd_b
Bibliography:
Rose et al. Diagnosis and treatment of vesicoureteral reflux and chronic pyelonephritis. UptoDate, 2004.
Surgical correction of reflux should be individualized and is probably indicated in the following settings:
* The presence of gross reflux and ureteral dilatation in a young child (particularly if under two years of age) even without marked scarring, since new scars will develop in up to 60 percent of these cases.
* A child who becomes infected and shows new scars because of incomplete compliance with medical therapy.
* A family that elects surgery, because compliance with daily antimicrobial therapy is too difficult to achieve or adequate follow-up is difficult for geographic reasons.
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.
Medical Weblog:
kevinmd_b
Bibliography:
Rose et al. Diagnosis and treatment of vesicoureteral reflux and chronic pyelonephritis. UptoDate, 2004.
