1. Antibiotic Therapy
Ureteric reflux happens in children when a deficiency or weakness in the muscle that connects the bladder and ureter allows urine to wash back up from the bladder into the kidney. If your child has this condition, the urine itself will pose no problem as long as it is clean, but if the urine becomes infected, this may lead to a kidney infection called pyelonephritis. If your child's reflux is mild to moderate, it can be treated with long-term, low-dose antibiotic therapy in order to prevent his urine from becoming infected. Your child's bladder muscles may develop as he grows, so the reflux might cure itself. An x-ray study will be necessary to determine whether reflux is still present before you can discontinue the antibiotic therapy, but your child's bladder muscles may be developing if he seems to be outgrowing any bedwetting or daytime bladder accidents.
2. Behavioral Modification and Biofeedback
If your child has ureteric reflux, she may benefit from behavioral-modification therapy, in which she will be trained to urinate on a set schedule, usually every 3 hours. She must also make sure to keep adequately hydrated and to eat a fiber-rich diet to prevent her from being constipated. Another technique that may be effective is a biofeedback procedure using surface perineal electrodes, which would be used along with pelvic-floor exercises to relax her perineum. A clinical study conducted between 1998 and 2002 showed that biofeedback therapy used along with pelvic exercises actually cured ureteric reflux in 50 percent of the patients studied.
3. Surgical Correction
If your child's case is severe or if antibiotic therapy is ineffective, the best option for treating ureteric reflux may be corrective surgery. Endoscopic treatment is minimally invasive and very effective, as it involves a cystoscope (miniature optical) device being inserted through your child's urethra and into his bladder. A bulking agent is then injected into his bladder at the points where the ureters enter it, forming small bulges, which make it harder for any urine to flow backwards. These bulges will also reduce the size of the openings from his ureters into his bladder, which will also make it harder for his urine to flow backwards. These openings will still be large enough for his urine to flow down into his bladder without a problem.
Your doctor may prefer to use the more traditional, if somewhat more invasive, procedure called ureteral reimplantation to treat your child's ureteric reflux. In this type of surgery, the child's ureter is moved to a place on the bladder where it can receive more muscular support.
