Urinary bladder reflux can cause a child to frequently run to the bathroom, tuck into their panties, or start soaking at night. This disease must be treated as soon as possible. For several years, bladder-urinary reflux can be treated without the use of a scalpel.
Naurinary bladder reflux(urinary reflux, urinary bladder drainage - OPM, retrograde drainage) affects about three percent of children.
The disease is where the urine, instead of flowing out of the bladder through the urethra, partially flows back into the ureters and even into the kidneys. This poses a serious threat to the he alth of the baby.
Vesicoureteral reflux: causes
Urine drainage occurs when the bladder sphincters malfunction. These are flexible seals that are located right at the opening of the ureters to the bladder.
Normally, when a child feels like he wants to pee, the bladder will constrict and the sphincters will tighten and close the ureters. The urine then flows down through the open urethra.
In contrast, when a child suffers from reflux, the bladder contracts, urine flows into the ureters, but instead of flowing outward, some of it comes back. When the contraction is over, the urine flows back into the bladder and stays there.
This can cause frequent inflammation and serious urinary tract infections. Urine backflow is usually the result of a congenital abnormality in the sphincter function at the exit of the ureter to the bladder.
It happens, however, that the disease develops, for example, after untreated inflammations and urinary tract infections, which make it difficult to empty the bladder completely.
Primary reflux or secondary reflux?
When the disease is caused by a congenital abnormality in the structure of the sphincter, it is referred to as primary reflux. If the urinary system is working poorly, e.g. due to a narrowing of the urethra, an abnormal number of kidneys (one or three) - reflux is referred to as secondary.
About 40 percent of OPM cases are classified by specialists as secondary, which means that sick children were not examined and treated in a timely manner. To diagnose bladder-urinary reflux, you need to undergo a test called voiding cystography.
The child is given a contrast agent intravenously. The baby is put under the X-ray machine. Kid,lying on the table, he should urinate. During peeing, several X-rays of the bladder and urethra are taken.
The test allows to precisely determine not only the degree of disease development, but also to detect other congenital defects of the urinary system, e.g. urethral stricture.
A complementary urodynamic test is also performed when OPM is diagnosed. The force with which the bladder contracts and relaxes while urinating is measured through a probe inserted into the bladder through the urethra.
Doctors use different forms of treatment depending on the advancement of the changes. In the early stages of development, OPM requires the administration of drugs that disinfect the urinary tract.
With more advanced disease, radical measures may be necessary. The most popular and least painful procedure for a child in such situations is the procedure consisting in injecting the ureters with special drugs. The injections are performed under local anesthesia or light anesthesia (the so-called stupid joke).
Unfortunately, in the case of a very advanced disease, surgery is necessary. Sometimes it even takes an hour and a half. It is performed under anesthesia. The doctor cuts the abdomen and surgically strengthens the bladder sphincter. After such surgery, the child must stay in the hospital for at least one week.
ImportantAt first, the disease often causes no symptoms. This makes it very difficult to make a diagnosis quickly.
Usually, only after secondary bladder infection, symptoms appear: abdominal or side pain, painful and frequent urination, a feeling of sudden pressure on the bladder.
Occasionally, blood may appear in the urine and the temperature may rise.
Recent studies show that urinary reflux is more and more common in families. If a condition is diagnosed in one of the children, others may also be sick. For this reason, ultrasound should also be performed on siblings.
It is extremely important, because unrecognized or poorly treated vesicourethral outflow can lead to kidney damage, and consequently also to their complete failure. Then the only salvation for the patient may be a kidney transplant.
Treatment of urinary reflux
Endoscopic treatment of urinary reflux has been used in Poland for several years. It involves injecting a special sealing substance through the urethra into the bladder.
This cuts urine outflow in the wrong direction. Until recently, we used silicone or Teflon preparations for this purpose. They did not always have a good effect on the body.
Recently, more and more often children are given a more modern preparation (deflux), the main ingredients of which are hyaluronic acid and dextranomer.They are substances of natural origin that do not cause allergic reactions and the body tolerates them well.
The endoscopic method has many advantages: it is safe, leaves no scars and causes no complications. The procedure takes 15-20 minutes. In most cases, the stay in the hospital is limited to two days.
The baby hates and his recovery is much faster. Until recently, all parents who wanted their children to have their bladder sphincter repaired using the latest deflux method had to pay over PLN 700 out of their own pocket.
Now, in hospitals that have signed appropriate agreements with the National He alth Fund, such treatments can be performed under he alth insurance.
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