Vesicoureteral reflux (pronounced Ve-sih-koh-yoo-REE-ter-uhl Ree-fluks) is a condition in which urine flows backward from the bladder towards the kidneys under certain conditions.

Normally, the urine produced in the kidneys is transported to the urinary bladder by fine tubes called ureters. The urine is stored in the bladder until it is time to void. When a person voids, the urine flows unidirectionally from the bladder out of the urethra. It does not normally flow back up the ureters. This is because the ureters are connected to the bladder in such a way that the backward flow of urine does not occur.

In children who suffer from Vesicoureteral Reflux, either the connection of the ureters with the bladder is defective (primary reflux) or the bladder pressure is so high that the mechanism to prevent backflow is overwhelmed. Protect your child with the best treatment. Dr. Geeta Kekre is the best pediatric surgeon in Pune. Make her your first choice for vesicoureteral reflux surgery in Pune.

The main concern with VUR is the occurrence of upper urinary tract infections. This means that if any bacteria enter the urinary bladder, the reflux can expedite the transport of these bacteria to the kidneys. An infection of the kidneys can lead to scarring and -over a period of time- permanent damage to kidneys. Hence, preventing infections, identifying them early and treating them aggressively are paramount to the management of VUR.

Primary VUR often resolves spontaneously in children upto the age of 5 years. However, these patients need to be monitored closely for the occurrence of infections and renal scars. If any of these occur, it may not be advisable to wait for spontaneous resolution. If left untreated, VUR can result in problems during adolescence and adulthood such as renal insufficiency and recurrent pregnancy loss in women.

In most cases, the suspicion of VUR is raised on prenatal ultrasound scans. Other symptoms include recurrent urinary infections with fever (>2 episodes a year), dribbling of urine and high blood pressure.

If your child is suspected to have VUR, your doctor is likely to order the following tests:

Vesicoureteral reflux treatment in Pune is highly individualized and depends on a number of factors.

In general, treatment is focused on preventing urinary infections and preserving kidney function.

Infants and young children diagnosed with primary VUR (where the structure of the urinary bladder and its junction with the ureters is normal) are closely observed. Preventive antibiotics may be given to ward off infection. Emphasis is placed on encouraging the child to void his or her bladder frequently and completely. Constipation is avoided and holding behavior is discouraged. Focus is placed on a fiber-rich diet and adequate oral fluid intake.

Children who do not show spontaneous resolution of VUR, those who have a structural abnormality resulting in Vesicoureteral Reflux, and those who develop recurrent urinary infections with fever may benefit from surgery. The operation involves placing the ureter further into the bladder so that the openings of the ureter are pinched closed when the bladder fills up and when the patient voids. Nowadays, these surgeries can be performed by:

Open technique- where an incision is made on the lower abdomen.

Laparoscopy- where the entire procedure is performed through tiny “keyhole” incisions. Dr. Geeta Kekre is the Best pediatric laparoscopic surgeon in Pune.

Robotic surgery- where the same procedure is performed through keyhole incisions using advanced robotic instruments allowing greater precision and maneuverability. For advanced treatment, prefer the best pediatric surgeon. Dr. Geeta Kekre is the best Pediatric robotic surgeon in Pune.