Vesicoureteral Reflux (VUR) | FAQ with Dr. Heather Di Carlo
(upbeat music) Vesicoureteral reflux is the retrograde flow of urine from the bladder up to the kidneys. The tubes that drain the kidneys are called ureters, and actually the urine flows from the bladder up to the kidneys via the ureters. (upbeat music) There are various ways we diagnose children with vesicoureteral reflux. One way is with antenatally detected hydronephrosis. That's swelling in the kidneys, that's detected on the prenatal ultra sound. The other way is when a child has a febrile urinary tract infection. Which prompts evaluation. (upbeat music) Symptoms of vesicoureteral reflux can include febrile urinary tract infection as well as findings on imaging.
Such as swelling in the kidneys and ureters. (upbeat music) Treatment options of vesicoureteral reflux include surgery as well as a procedure to increase the tunnel length of the ureter and the bladder. Surgery includes actually lengthening the tunnel of the ureter into the bladder surgically to allow a good flap valve mechanism that doesn't allow the urine to go up to the kidneys. A procedure called dextranomer hyaluronic acid injection is done cystoscopically and this also can increase the tunnel length. (upbeat music) Ureteral reimplantation is the procedure, the surgical procedure, used to treat vesicoureteral reflux in children that are on prophylactic antibiotics and get break through infections in other words, they're getting infections when they're taking their prophylactic antibiotics appropriately. We actually want to treat the reflux to prevent scaring of the kidneys. This includes a small incision in the lower abdomen to re implant, or make the tunnel longer of the ureter into the bladder.
Thus treating the reflux. (upbeat music) Ureteral reimplantation is a surgical procedure to lengthen the intramural tunnel of the ureter and the bladder. This is done through a small incision below the bikini line called a fan and steel incision. The procedure itself takes about and hour and a half to do and recovery is usually about a day or two in the hospital post operatively. (upbeat music) Not all children with vesicoureteral reflux are candidates for reimplantation we usually observe these children and see if they can outgrow their reflux prior to proceeding with surgery. (upbeat music) Your child should have this procedure at done at the Johns Hopkins Childrens Center if they need it because we have world class experts that are experts in this type of surgical management. As well as the medical management.
We have a wonderful multi disciplinary team that includes not only the pediatricians, pediatric urologists, and pediatric nephrologists that will care for your child. (upbeat music) (children laughing).
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