Dr. MJ Bazos MD,
What is a urinary
When urine from the bladder
flows back up into the kidneys, this is called reflux. Urine normally goes only
one way. When urine flows back up from the bladder to the kidneys, germs get
into the kidneys. This can lead to infection in the urinary tract. If reflux
isn't noticed, the repeated infections can lead to scarring of the kidneys.
Reflux happens in about one-third of children
have urinary tract infections (called
UTIs for short)
Does a UTI mean
there is something wrong with my child's urinary
Most children who have a UTI
have a normal urinary tract. Just as some children get ear infections even
though their ears are normal, some children get UTIs even though they have a
normal urinary tract. However, some children with UTIs may have something wrong
with their urinary tract. Your doctor may order special tests to find out. This
is more likely if your child is very young at the time of his or her first
infection, or if he or she has repeated
What kind of tests will
the doctor perform?
several tests that look at the urinary tract. An ultrasound of the kidneys and
bladder is a painless test that gives your doctor a good look at the kidneys and
A bladder x-ray, called a
voiding cystourethrogram (VCUG), is a good way to look at the bladder. A small
tube is put into your child's bladder. A liquid is passed through the tube into
the bladder. This liquid shows up on x-ray. X-rays are then taken as the bladder
fills and while your child urinates. This study gives good pictures of the
bladder and urethra. It is used to see if your child has reflux.
Another test that is sometimes used in
children with UTIs is a kidney scan. For this test, a small amount of
radioactive medicine is put into your child's blood stream with an IV line.
Pictures of the kidneys are then taken with a special camera. This is a very
good test for finding scarring in the kidneys. It is most commonly used in
children known to have reflux.
intravenous pyelogram is another test that can be used to look at the kidneys
and urinary tract. It is a lot like a kidney
Which of these tests is ordered
for your child depends on your child's age, gender, how many infections he or
she has had, and how bad the infections were.
How is urinary reflux treated?
Reflux tends to go away on its
own. So most children with reflux don't need treatment other than seeing their
doctor regularly. However, some children with reflux need to take an anitbiotic
every day to prevent UTIs. Some frequently used medicines are nitrofurantion
(one brand name: Furadantin) and trimethoprim/sulfamethoxazole (some brand
names: Bactrim, Septra).
Most children with
urinary reflux don't need surgery. A few children who continue to get UTIs while
they are taking antibiotics, who develop new scarring of the kidney or have
serious reflux, or who can't take antibiotics may need surgery. If your child
needs surgery, your doctor will discuss the options with you.