Incidence Of Vesicoureteric Reflux In Children With Urinary Tract Infection And Methods Of Diagnosis And Management

Vesicoureteric reflux (VUR) is the retrograde flow of urine from the bladder into the ureters. It is the most common urological anomaly in children, and a major cause of end-stage renal failure and hypertension in both children and adults .Vesicoureteric reflux (VUR) is an anatomic and functional disorder with potentially serious consequences. Vesicoureteric reflux is a common finding in pediatric practice that occurs in about 1% of children and is often familial, with several genetic loci probably involved. The majority of low-grade cases have a tendency to resolve spontaneously during childhood. However, VUR has been identified as a risk factor for the development of urinary tract infections (UTI) and is present in one third of young children presenting with this problem. In addition, some children with high-grade VUR have already renal lesions before the advent of any UTI. An estimated 30–40% of children under the age of 5 years who develop a urinary tract infection (UTI) have VUR VUR can be further categorized as either primary or secondary. Primary VUR in children is frequently attributed to an abnormally short intravesical tunnel at the ureterovesical junction, the more severe the abnormality, the worse the VUR. Secondary VUR occurs when reflux is induced by abnormally increased bladder pressures, such as those seen with urethral obstruction or neurogenic bladder dysfunction. The risk of developing renal scars is higher in the first years of life. The current management of vesicoureteral reflux (VUR) focuses on the prevention of urinary tract infections (UTI), with curative surgery being limited to those children that fail conservative measures. This is based on the assumption that UTIs are preventable with the use of prophylatic antibiotics, leading to reduction of renal scarring, and the possibility that VUR in children can resolve spontaneously. Endoscopic treatment for vesicoureteral reflux has become an established alternative to long-term antibiotic prophylaxis and ureteral reimplantation.