vesicoureteral reflux
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Introduction
Backflow of urine from the bladder into the ureter, unilaterally or bilaterally, during rest or especially during urination.
Etiology
- congenital
- secondary to obstruction of the urinary outflow tract
- any disease involving the urinary ureteral orifices
Diagnostic procedures
Complications
- recurrent urinary tract infections[7]
- hydronephrosis
- renal scarring
- chronic renal insufficiency
Management
- antibacterial prophylaxis
- daily Bactrim associated with fewer recurrences of urinary tract infection (UTI) in young children (26% vs. 37%)[6]
- 3 mg of trimethoprim + 15 mg of sulfamethoxazole per kg body weight
- number needed to treat: 8 children for 2 years to prevent 1 UTI[6]
- does not prevent renal scarring[6]
- of no benefit[4][5]
- reduces risk of recurrent urinary tract infection but increases risk of multidrug resistant UTI[8]
- daily Bactrim associated with fewer recurrences of urinary tract infection (UTI) in young children (26% vs. 37%)[6]
- bowel & bladder hygiene
More general terms
More specific terms
Additional terms
References
- ↑ Stedman's Medical Dictionary 26th ed, Williams & Wilkins, Baltimore, 1995
- ↑ Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
- ↑ Journal Watch 22(2):15, 2002 Smellie JM, Jodal U, Lax H, Mobius TT, Hirche H, Olbing H; Writing Committee, International Reflux Study in Children (European Branch). Outcome at 10 years of severe vesicoureteric reflux managed medically: Report of the International Reflux Study in Children. J Pediatr. 2001 Nov;139(5):656-63. PMID: https://www.ncbi.nlm.nih.gov/pubmed/11713442
- ↑ 4.0 4.1 Garin EH, Olavarria F, Garcia Nieto V, Valenciano B, Campos A, Young L. Clinical significance of primary vesicoureteral reflux and urinary antibiotic prophylaxis after acute pyelonephritis: a multicenter, randomized, controlled study. Pediatrics. 2006 Mar;117(3):626-32. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16510640
Wald ER. Vesicoureteral reflux: the role of antibiotic prophylaxis. Pediatrics. 2006 Mar;117(3):919-22. No abstract available. PMID: https://www.ncbi.nlm.nih.gov/pubmed/16510674 - ↑ 5.0 5.1 Pennesi M et al. Is antibiotic prophylaxis in children with vesicoureteral reflux effective in preventing pyelonephritis and renal scars? A randomized, controlled trial. Pediatrics 2008 Jun; 121:e1489 http://dx.doi.org/10.1542/peds.2007-2652 PMID: https://www.ncbi.nlm.nih.gov/pubmed/18490378
- ↑ 6.0 6.1 6.2 6.3 The RIVUR Trial Investigators Antimicrobial Prophylaxis for Children with Vesicoureteral Reflux. N Engl J Med. May 4, 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24795142 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMoa1401811
Ingelfinger JR and Stapleton FB Antibiotic Prophylaxis for Vesicoureteral Reflux - Answers, Yet Questions. N Engl J Med. May 4, 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/24795143 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMe1404774 - ↑ 7.0 7.1 Tullus K. Vesicoureteric reflux in children. Lancet 2015 Jan 24; 385:371 PMID: https://www.ncbi.nlm.nih.gov/pubmed/25164069
Tullus K. Vesicoureteric reflux in children. Lancet 2015 Jan 24; 385:371 PMID: https://www.ncbi.nlm.nih.gov/pubmed/25164069 - ↑ 8.0 8.1 Selekman RE, Shapiro DJ, Boscardin J et al. Uropathogen resistance and antibiotic prophylaxis: A meta- analysis. Pediatrics 2018 Jul; 142:e20180119 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29954832 <Internet> http://pediatrics.aappublications.org/content/142/1/e20180119