So, what is VUR? VUR stands for vesicoureteral reflux – this is a pediatric condition that allows urine to flow backwards – from the bladder to the kidneys – through one or both of the connecting tubes (ureters).
I have never heard of VUR before nor have known of any child diagnosed with this condition so learning about VUR consumed my nights and days. There’s always something new to learn each time I open a link from the articles I read.
VUR is an anatomical condition which could be diagnosed as early as pregnancy – through ultrasound. At 21 weeks of my current pregnancy, I immediately went to check with my Obgyne for an ultrasound diagnosis. My baby is fine, he said. But he added, it was too early to tell. In some cases, VUR is diagnosed through ultrasound. In other cases, VUR is diagnosed immediately after birth. Others are diagnosed when the child is between 1 – 3 years old. And for others, VUR is diagnosed when the kidney has been totally damaged:-). But when an older child has VUR, the younger sibling is likely to have one, too.
I’ve read that VUR itself is not dangerous. The danger lies when the urine becomes infected and some of which goes back to the kidney. That is why, when a child has VUR it is important to prevent urinary tract infection (UTI). In most cases though, VUR is diagnosed after a child has UTI. Other pediatricians make it a point to conduct follow-up tests for children diagnosed with UTI. In some cases, children undergo ultrasonogram to check their kidneys. If scars are seen, children are referred to the corresponding specialists. A nephrologist can discuss about the kidney scars present. Depending on his assessment, he may recommend further tests. A DMSA (dimercatosucconic acid) scan may be necessary to further check on the scars on the kidney. To check if a child has VUR, the doctor may recommend a VCUG (voiding cystourethrogram) test. The VCUG is an X-ray procedure where the radiologist will watch the monitor while the bladder is filling up to see if any liquid goes back into one or both ureters.
If a child has VUR, the importance of the VCUG lies in its determination of the grade of the VUR. There are 5 grades, the least severe of which is Grade 1. Needless to say, the most severe is Grade 5. For Grades 1 – 3, the VUR may spontaneously correct itself as the child matures. But the child would need to take a low-dose antibiotics daily to prevent infection until the VUR is corrected. This make take 12 months to 18 months or even more of the daily intake of low-dose antibiotic. The frequency (more aptly, the prevention) of the infection is very vital to the condition of the kidney. For, at the end of the day, it is really the kidney which is being protected here. For those who have Grades 4 – 5, it is highly unlikely that the VUR will correct on its own. A urologist is most likely to (highly) recommend surgical procedure.
A surgical procedure for a very young child is not something every parent has to face with. This is the very reason why I am blogging about this.