The condition in which urine flows in the opposite direction or from bladder back into the ureter again, is called vesicoureteral reflux (VUR). It mostly affects infants and young children, but it can happen at any age. While a lot has been discussed about vesicoureteral reflux in children, it is important to know about vesicoureteral reflux in adults, its causes, symptoms and treatment.
Vesicoureteral Reflux in Adults
Normally, urine flows in a single direction, from kidneys to the bladder and then to the urethra. Urine forms in the kidneys, gets filtered out via the ureters into the bladder and then exits the body through the urethra. In vesicoureteral reflux in adults, urine tends to flow in the wrong direction, i.e. from the bladder back into the ureters.
Vesicoureteral reflux in adults occurs due to improper functioning of the valve connecting the ureter and the bladder, any urinary tract infection or a congenital defect. Vesicoureteral reflux in adults can trigger an infection as bacteria can develop in the trapped urine. Vesicoureteral reflux is often diagnosed after urinary tract infection (UTI). This health issues generally resolves on its own but may require treatment in some cases. However, in case of prolonged vesicoureteral reflux in adults, the patients must seek medical help to prevent kidney damage. Read on to know all about vesicoureteral reflux in adults, causes, symptoms and treatment.
Types of Vesicoureteral Reflux
There are 2 types of vesicoureteral reflux – Primary vesicoureteral reflux and secondary vesicoureteral reflux.
- Primary vesicoureteral reflux is the condition wherein an individual is born with a faulty valve between one or both ureters and the bladder. Primary vesicoureteral reflux generally resolves on its own with time, as the valve and ureter function improve.
- Secondary vesicoureteral reflux occurs when pressure triggers the urine to flow backward, usually due to a blockage in the urinary system. This type is commonly seen as vesicoureteral reflux in adults. In secondary vesicoureteral reflux in adults, a bladder infection can trigger swelling of the ureters, which in turn causes the urine to flow back to the kidneys. This often needs treatment.
Symptoms of Vesicoureteral Reflux in Adults
Symptoms of vesicoureteral reflux in adults depend on the severity of the condition. In case of mild vesicoureteral reflux in adults, urine moves up for a short distance into the ureter. In case of severe vesicoureteral reflux in adults, it can result in kidney infections and permanent kidney damage.
Vesicoureteral reflux in adults is most commonly indicated by urinary tract infection. Some signs of UTI or bladder infection are fever, abdominal pain, fussiness, cloudy and smelly urine, blood in the urine, urgency to urinate, urinating with pain, burning sensation when urinating, incontinence, bed wetting and dribbling urine. These can be considered as symptoms of vesicoureteral reflux in adults too. Kidney infection is specially indicated by signs like fever, vomiting, abdominal and back pain, and fatigue.
However, urinary tract infections can develop without any notable symptoms too. In which the symptoms of vesicoureteral reflux in adults may not be clearly noticed. If left untreated for long, the infection can spread to the kidneys and can cause permanent scarring and other problems. Symptoms of vesicoureteral reflux in adults that has not been treated for long includes high blood pressure, protein in urine, palpable abdominal mass, scarring of kidney tissue, poor weight gain and kidney failure.
Diagnosis of Vesicoureteral Reflux in Adults
One should consult a doctor if experiencing a persistent and powerful urge to urinate, a burning sensation while urinating, abdominal pain, and diarrhea, loss of appetite, lethargy, vomiting and fever with no obvious reason. The doctor may use tests like ultrasound scan, urine test, voiding cystourethrogram (VCUG) and radionuclide cystogram (RNC) to detect UTI and VUR.
Treatment of Vesicoureteral Reflux in Adults
Treatment of vesicoureteral reflux in adults depends on the patient’s medical history, age, overall health, severity and type of the condition.
- In case of primary vesicoureteral reflux in adults, the doctor may decide to wait and watch till the problem resolves on its own. If required, the doctor may also prescribe certain medicines for bladder control. Antibiotics are also administered to prevent infection.
- In advanced cases, treatment of vesicoureteral reflux in adults may include surgery. The surgery is performed to fix the faulty valve and prevent urine from flowing towards the kidney.
- In extremely severe cases, the kidney and scarred tissue may also have to be removed. Then, the treatment of vesicoureteral reflux in adults includes surgical procedures like laparoscopy, endoscopy or open surgery.
Deflux is a less invasive option that is used to restrict the urine from flowing backwards. Treatments for secondary vesicoureteral reflux in adults aim at removing the blockage which is responsible for triggering the reflux. This can be done by administering antibiotics, using a catheter to drain the ureter, or surgery.