1. Antibiotic Therapy
If your child is diagnosed with vesicoureteral reflux, a condition in which urine washes back up through the ureters and possibly into the kidneys, the primary treatment will require daily low doses of antibiotics. Your child will take cephalosporin, trimethoprim-sulfamethoxazole, nitrofurantoin or amoxicillin until the reflux resolves itself or until he is at least 5 years old. The antibiotics prevent infection. If the kidneys were to become infected, renal scarring many result and the kidneys may not fully grow to a healthy adult size. Even slight scarring in one kidney may cause your child to experience high blood pressure later in life.
2. Nonsurgical Management
Your pediatrician may determine that the reflux is related to an underlying problem, such as infrequent urination, abnormal bladder activity or constipation. In this case, the underlying problem must be treated. If the cause is related to your child's toilet habits, you can employ methods for bladder training, such as getting him to use the potty on a set schedule and keeping track of every time he goes. In other cases, it may be determined that the cause is dietary. For example, you may be drinking too much or too little, not getting enough fiber or eating and drinking items that irritate the bladder. In these cases, you should make any changes in your child's diet that your pediatrician recommends. In most cases, children with mild-to-moderate (grades I through III) cases of vesicoureteral reflux will grow out of it, although it is important for a doctor to monitor them closely until all signs of reflux disappear. It also will be necessary for the doctor to aggressively treat any potential urinary infections to prevent harm to the kidneys.
3. Corrective Surgery
If your child is diagnosed with high grade (IV to V) vesicoureteral reflux or her mild-to-moderate case is unresolved after several years of monitoring and antibiotic therapy or if she contracts a urinary infection despite the antibiotics, the doctor must perform surgery to correct the reflux. The traditional approach, called a ureteral reimplantation or ureteroneocystostomy, opens the bladder to create a new, longer tunnel that allows the ureter to pass through the bladder wall. Another surgical method uses an endoscope to inject a bulking agent, such as Deflux, at the ureteral opening to create a bulge that the urine cannot flow past. This procedure is less invasive than a ureteroneocystostomy, but it is also considered less effective.
