What Is Ureteral Reflux?

Jillian O Keeffe

The ureters are the tubes that move urine from the kidneys to the bladder. In a healthy individual, urine only flows into the bladder and not back into the kidneys. Ureteral reflux is a description of conditions that cause the urine to flow backward, and is more commonly known as vesicoureteral reflux. Physical abnormalities and urinary tract infections are the most common causes of this condition, which can potentially result in kidney damage if left untreated.

Catheter bags must always remain below the bladder to prevent ureteral reflux.
Catheter bags must always remain below the bladder to prevent ureteral reflux.

Most often, ureteral reflux is first noticed in young children and babies. Often, if a physical problem is causing the backflow of urine, it is a problem with the valve that is supposed to direct the urine movement into the bladder, and prevent the urine from flowing back up. Another possible physical cause is that the area between the ureter and the bladder is malformed. This type of ureteral reflux is also called primary ureteral reflux, or primary vesicoureteral reflux.

Secondary vesicoureteral reflux is the other main group of causes of the urine backflow. Typically, an infection of the urinary tract is the cause of a secondary condition, as the infecting microbe can damage the physical aspects of the urinary tract. When a doctor suspects that a child has ureteral reflux, he or she generally performs a scan such as an ultrasound or an X-ray. Some procedures involve the insertion of a catheter into the bladder, and placement of a dye in the tract, so the resulting image shows backflow of dye into the ureters. An ultrasound before birth may even be sensitive enough to identify the presence of a problem before a child is born.

Symptoms of the condition include a lack of control over urination, dribbling of urine and an inability to put on weight. An affected child may also have a swelling of the kidney area, which a doctor may be able to spot during a physical examination. Some kids can grow out of primary reflux, as the body develops further, or, if medical treatment is necessary, surgery or medication can help. Infections as an underlying cause of reflux can also be treated with antibiotics.

An important risk of ureteral reflux is that the kidneys can become damaged from exposure to the backflowing urine. This situation is called reflux nephropathy, and severe cases can even cause the kidney to shut down. Milder cases, though, may resolve themselves once the initial problem is fixed, and the patient may experience no further problems.

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