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Vesicoureteral Reflux

Vesicoureteral reflux (VUR) is one of the most common conditions for which we see children.  Up to 1/3 of children with Urinary Tract Infection (UTI) have VUR.  It is usually discovered due to UTIs , but can also be discovered incidentally or due to kidney dilation (hydronephrosis) noted on prenatal ultrasound.  Many children will “outgrow” VUR with time (spontaneous resolution).  For children with normal bladder function, VUR itself is not harmful to the kidney.  However, the presence of VUR increases the risks of UTIs until it resolves or is surgically corrected.  Most children are maintained on a low-dose once daily prophylactic (preventative) antibiotic until the VUR resolves or is corrected or becomes very minimal.  VUR can be one-sided or both sided and varies in severity.  The more severe it is, the higher the risk of UTI problems and the longer it will likely take before the VUR resolves.  We will discuss your child’s VUR grade and risk of UTIs at each visit.  Additionally, we will discuss your child’s bowel and bladder habits, as this is strongly related to both VUR resolution and UTI problems.

We treat hundreds of children with VUR of all varieties and severities each year.  Each child with VUR is different, and there is no “one size fits all” treatment plan for this condition.  At each visit, options for continued treatment are discussed including pros/cons of each option.  Parental preferences are extremely important for management of this condition, as there are usually several good treatment options available.  We strive to provide parents with an honest assessment of their child’s risk of UTIs and likelihood of VUR resolution, along with reasonable treatment options.  A decision is then made together, with parental preferences as the primary driver of the treatment plan.

We perform hundreds of VUR correction procedures (under anesthesia) each year, from minimally invasive procedures using a scope (no incisions) inserted into the bladder through the urethra, to open bladder surgery through a small “bikini” incision.  The decision of when to proceed to surgery and which procedure is best for your child will also be made together, with parental preferences at the foremost of the decision.