Among the various diseases of the genitourinary system, vesicoureteral reflux in children is a serious problem for modern medicine. This disease gives a great discomfort to the sick and without adequate treatment can lead to disability.
The diagnosis of DMR in a child - what is it?
Bladder ureter reflux or abbreviated PMR is the process when urine entering the urea is for some reason returned back to the renal pelvis or stagnant in the ureter. Such a systematic condition causes infection in the form of pyelonephritis, and in the worst case, the wrinkling of the kidney. In some cases, vesicoureteral reflux in children can pass by itself, although during this time in the kidney there are destructive processes. In most cases, prolonged medical or surgical treatment is required.
Bladder-ureteral reflux - causes
Insidious disease of vesicoureteral reflux, the causes of which can be both congenital and acquired, is characterized by a violation of the system of valves located in the ureter. Disease in 70% of cases is diagnosed in children under 1 year. The inconsistency of the valve in the ureter can be both congenital - primary PMR, and acquired - secondary PMR. In the second case, the causes are cystitis (chronic), leading to overgrowth of the mouth in the valve region and a decrease in its retention capacity due to a constant inflammatory process.
The degree of vesicoureteral reflux in children
The disease is vesicoureteral reflux, a degree that is of great importance, amenable to treatment depending on the stage. The fewer soft tissues involved in vesicoureteral reflux in affected children, the greater the chances of the child recovering. Distinguish:
- I degree - urine falls only in the pelvic part of the ureter, without flowing further.
- II degree - the outflow of urine is seen throughout the entire ureter and partially the renal pelvis.
- III degree - this stage is characterized by an increase in the pelvis, where the urine is casting, without the expansion of the ureter.
- IV degree - renal pelvis and ureter have significant changes in the form of enlargement.
- V degree - thinning of the walls of the kidney due to casting of urine and as a consequence - its wrinkling and oppression of functions.
In addition, the severity of the disease is judged on the reduction of kidney function. Distinguish:
- vesicoureteral reflux of the 1st degree - when the changes are minimal and the kidney function is not affected;
- 2-degree vesicoureteral reflux in children is characterized by a decrease in the functionality of the paired organ by 30%
- 3-degree vesicoureteral reflux - when the kidneys work at 60% of full strength;
- 4-degree vesicoureteral reflux is the most serious stage of the disease, because kidney function is reduced by more than 60%.
Bladder ureter reflux in children - symptoms
Ureteral reflux in children has characteristic symptoms for this disease, which are sometimes taken for the symptomatology of pyelonephritis . To as soon as possible to relieve the condition of a sick kid, you need to apply for diagnostics to qualified doctors. Parents should be alerted if the child complains about:
- headache;
- swelling;
- feeling of thirst;
- raspiranie in the region of the waist;
- high pressure;
- prolonged temperature rise;
- pain after urination
- altered color of urine (turbidity, frothiness).
Bladder and ureter reflux - diagnosis
In order to diagnose MTCT in a child, you should find a good clinic specializing in pediatric urology. Doctors conduct such a complex of examinations to determine the degree of the disease:
- primary examination by a urologist and making an anamnesis;
- general analysis of urine ;
- bacteriological analysis of urine (bakopsev);
- Ultrasonography of the kidneys and adjacent organs using the Doppler;
- scanning of the genitourinary system;
- cystoscopy;
- urethrocystography;
- radiography.
How is vesicoureteral reflux treated?
Such a disease as vesicoureteral reflux in children, whose treatment can last a long time, has two types - active and passive. In the first case, the reverse casting of urine occurs only with urination, and in the second, this process does not depend on external causes. Vesicoureteral reflux is treated successfully in children, especially at an early age. Cure is almost 100%. There are two types of treatment - conservative and surgical. In outpatient settings:
- diet therapy;
- prescribing drugs to reduce pressure;
- taking antibiotics;
- phytotherapy;
- acupuncture;
- hourly catheterization of the bladder;
- electrophoresis.
Surgical intervention is indicated if:
- alternative treatments do not work;
- In addition to reflux, there are accompanying abnormalities of the structure of the urinary tract;
- relapse of urinary infections that do not respond to antibacterial therapy.
Bladder and ureter reflux in children - clinical recommendations
Due to the fact that ureteral reflux in children is considered a serious problem of both medicine and the state, modern technologies for its treatment are constantly being developed and introduced. I and II degree of the disease is treated non-surgically, which in 65% of cases gives positive dynamics. But if the inflammatory process can not be stopped, even at these stages it is recommended to perform a low-traumatic operation that will forever forget about the problem.
Endoscopic correction of vesicoureteral reflux in children
The most modern and effective method, capable of 97% defeating vesicoureteral reflux is an operation called "endoscopy". With her, a special device endoscope, a low-traumatic intervention, which lasts only 15 minutes. The whole procedure is under mask anesthesia and for 3-4 days a small patient is already prescribed for outpatient care home.