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Information for Parents

Vesicoureteral Reflux (VUR)

  • What is this disease?

    • Vesico-ureteric reflux (VUR) occurs when the valve between the ureters and the bladder is not working properly. Urine can flow backwards into the ureters, sometimes as far as the kidneys causing infection and damage to kidneys.

  • How it is diagnosed?

    • VUR is diagnosed and graded by MCU (Micturating cystourethrogram).USG and DMSA are other means to help in diagnosis and follow up.

  • How it is treated? 

    • The options of treatment include continuing antibiotic prophylaxis (CAP),endoscopic injection like Deflux or Dexell ( Dextranomer/Hyaluronic Acid Injection), and ureteric reimplantation (open, laparoscopic or robotic). The surgery is recommended for cases with recurrent UTI, in high grade reflux etc. Your surgeon is best person to guide about same.

  • When it should be operated?

    • The surgery for VUR, if indicated, is commonly done after 1 years  of age.

  • Are there other alternative methods of treatment?

    • In indicated cased , surgery is the treatment option. Otherwise child need follow up with antibiotic prophylaxis(CAP), regular USG, blood pressure measurements, urine and blood tests.

  • What all I need to know before my child surgery?

    • Read “All you need to know before your child’s surgery” information booklet in website

  • How is the surgery done?

    • The surgery can be done by both open and minimally invasive means. In both of these, a tunnel is created in bladder and ureter placed inside that to take care of reflux. Most of the surgeons would like to place a DJ stent during the procedure. In Endoscopic surgery, a pediatric cystoscope is used to inject  Dextranomer/Hyaluronic Acid (Dexell®) at ureteric opening, creating a mound, which prevents reflux.

  • Remarks

    • For more details of surgery, contact your surgeon

  • Related Photographs and videos

    • Few photographs of steps done by me and video link are given here for learning purposes

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