Some mothers' questions about children (Part two)

Summary of key signs of Urinary infections by age

VESICO-URETERAL REFLUX (VUR)

It is called the backward flow of urine from the bladder towards the kidneys, named VUR. VUR does not have specific signs, however, some phenomena should always raise suspicions.

When should it be suspected?

In newborns and infants: failure to gain or weight loss, lack of appetite, temperatures seemingly without cause, prolonged vomiting or diarrhea, skin paleing, strong urine smell. In older children: frequent urination, burning or pain during urination, back pain, involuntary urination during sleep (for ages over 5 years), temperatures without cause.

Older children sometimes feel a strong immediate pain in the kidney area (reflux pain) or urinate intermittently (double urination); two signs with unique values for seeking further examinations. For young children, these two signs not that they do not exist, but cannot be noticed due to age reasons.

In most cases, VUR is discovered during the follow-up of a UTI or incidentally, during an ultrasound for other purposes. Today, thanks to Ultrasound during pregnancy, a good part is discovered prenatally.

How is it confirmed?

Ultrasound is one of the important examinations, for all ages. Another examination is the plain Cystography or during urination (micturitional). Through a catheter, the bladder is filled with physiological solution and a contrast substance, then filming is done. In children who control urination, the filming is done after filling, during urination, and at the end (to see if there is any urine left) this is called micturitional cystography.

Depending on the case, Urography, renal scintigraphy, urodynamic examinations (flowmetry, cystomanometry, etc.) may be performed aiming at the functional study of the urinary elimination pathways. In conclusion, not only the reflux can be discovered but also its grade from I-V can be determined.