Join Dr. Koushik Herle, Consultant - Paediatric and Neonatal Surgeon at Manipal Hospital Sarjapur Road, as he shares valuable ...

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Vesicoureteral Reflux I Dr. Koushik Herle I Manipal Hospital Sarjapur Road

[Music] hi I'm Dr Kik I'm consultant pediatric surgeon and a pediatric urologist at manipal hospital saur road I'll be talking about a condition called as vric reflux this is a Urological condition where the urine from the urinary bladder travels up towards the kidney now imagine kidney and bladder to be a one-way Road where the urine flows from the kidney along the uror into the bladder there is never in life that the urine traces a reverse part that is ascending from the bladder to the kidney so when this happens that is urine entering in the wrong direction that is called as vric reflux in this image you can notice that the urine instead of completely going down from the bladder partially is also entering into the uror this is a normal uror where the direction of flow of urine is only from kidney towards the bladder but here it is ascending upwards this condition is called as vric reflux and because there is excess urine getting collected within the kidney and the uror there is bulging of uror and the kidney so this is hydro uron nephrosis caused because of vric reflux this is a condition which can lead to multiple U and damage to the kidney function there are five grades in vesc reflux from grade 1 to five the minor grades usually do not cause much of an issue but the major grades causes swelling in the kidney swelling of the uror and repeated urinary tract infection this urinary tract infection can occur as early in infancy even by 2 or 3 months of age it is hence said that any child who has urinary tract infection before they are toilet trained that is when they're less than 2 years and the child has a urinary tract infection it is important to do an ultrasound test to detect hydrosis it may not be just V but other pediatric Urological conditions which is causing Hydro nephrosis and hence an ultrasound is a must none of the UTI should be treated with just antibiotics but an urine culture has to be done coming back to V how is it treated the bladder from the birth till the child attains toilet training and even up to 5 years keeps undergoing cellular level changes and also changes as a structure with this many a times the veso petric reflux especially the minor grades of grade 1 and two can get autoc corrected grade 3 4 and 5 can come down in grade and become grade one or two with growth so during this period what we do is observe the child we start the child on something called as a europrofile axis which is an antibiotic lower dose which is given doesn't have side effects and it is given only at night this helps to prevent many urinary tract infections in future once the child is being followed up for an year or so and we see that there are no urinary infections at all then the child can be safely followed up in future too till he or she attains 5 years of age if the child has repeated urinary tract infections even when on europrofile axis then we also do dmsa scan which is a nuclear medicine scan and if this shows something called as scar on the kidney and this scar is growing both in number and in size then these are the two criteria where we need to operate on this child if there is none of these then the child can be safely followed up till 5 years and see if there is an auto resolution of the condition coming to surgery the surgery is called URC reimplant where the uror after connecting to the bladder The Junction is operated and we make sure that the urine doesn't enter back into the urum so vesic URC reflux requires a close followup so that the kidney function is preserved the child doesn't have urinary tract infections and it's a completely correctable condition if proper advise is sought and parents adhere to the treatment protocol completely meet a pediatric urologist and clarify any more doubts on V thank you [Music]

Dr.

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