| An anatomic abnormality in the way the kidneys, | | | | seen on the x-ray with the help of the dye that |
| bladder and urethra are hooked up, that can | | | | outlines the bladder and urethra. If VUR is present |
| cause recurrent bladder infections is present to | | | | the x-ray will show the dye backing up through |
| children sometimes. Three possible abnormalities | | | | the ureters into the kidneys. The dye does not |
| are: tight or posterior urethral valves, | | | | produces damage the bladder or kidneys, and it is |
| vessico-ureteral reflux (VUR) and abnormal | | | | flushed out quickly with urinating. This test is |
| kidneys or ureters. | | | | invasive and can be painful and scary for a child |
| In the first case normally the valve or sphincter | | | | but it's the one that can detect problems with the |
| keeps the bladder from emptying but sometimes | | | | urethra and ureters. Unfortunately very little |
| they can be too tight or in the wrong position. | | | | information about the kidneys is given by this |
| The bladder can not be empty completely and | | | | test. |
| the urine can back up and cause backpressure on | | | | Intravenous pyelogram (IVP) involves injected |
| the kidneys. This can cause a dilation of the | | | | dye through an IV into the blood stream. Outlining |
| kidneys named hydronephrosis which can lead to | | | | the structure of the kidneys on x-ray is shown |
| serious kidney damage. Kidney damage can | | | | by the dye that travels through the kidneys and |
| appear at newborns born from in utero | | | | into the urine. VUR or urethra problems can not |
| backpressure, or can develop during the first few | | | | be seen with this test. |
| months of life. Rarely this condition occurs in | | | | Nuclear medicine scan shows the kidneys in such |
| males, but does need to be diagnosed quickly. A | | | | a way that checks the kidney function and |
| weak urine stream is one clue to this problem. | | | | checks for scars in the kidneys. |
| Vessico-ureteral reflux (VUR) occurs where the | | | | In the case of abnormality presence some tests |
| urine tubes, called ureters, from the kidneys | | | | are recommended by doctor. So an ultrasound |
| empty into the bladder. The urine from the | | | | and VCUG should be done in these instances: |
| bladder is prevented by one-way valve to go | | | | newborns who have a single bladder infection, |
| back up into the ureters and kidneys. The urine | | | | infants less than one year of age who have a |
| can go backwards and cause backpressure on the | | | | second bladder infection and older children who |
| kidneys, or hydronephrosis at children which are | | | | have had more than three or four infections. |
| born with immature ureter valves. Over time the | | | | A referral to a pediatric urologist or nephrologist is |
| backpressure can damage the kidneys. | | | | necessary when these tests are normal, but the |
| There are very rare cases when the kidneys, or | | | | child continues to have problems with infections. |
| the tubes that drain them into the bladder, can | | | | An IVP will be done if the specialist will decide. A |
| develop abnormally. The urine is prevented to | | | | surgical specialist is called urologist and a |
| drain properly into the bladder and this can lead to | | | | non-surgical specialist is called nephrologist. If an |
| infections. | | | | abnormality on these tests appear doctor may |
| Different radiology tests are used to look for | | | | recommend a specialist for appropriate treatment. |
| structural problems involving the bladder and | | | | A daily low-dose of antibiotics can be given to |
| kidneys. Ultrasound is painless and non-invasive. If | | | | children who have recurrent bladder infections to |
| a structural problem with the kidneys or ureters | | | | control any bacteria that may get into the |
| exists, or if any hydronephrosis (back-pressure) is | | | | bladder. Prophylactic antibiotics are used when |
| present ultrasound can show that. VUR or a | | | | children with known anatomic abnormalities make |
| urethral valve problem cannot be found out with | | | | them prone to infections, and when children |
| an ultrasound. | | | | without abnormalities continue to have infections |
| Voiding Cysto-urethrogram (VCUG) is a test that | | | | despite all the above non-medical prevention. |
| involves restraining an infant or child, inserting a | | | | Usually children will take an antibiotic for six to |
| catheter through the urethra into the bladder, | | | | twelve months and after treatment will come |
| injecting a dye into the catheter, pulling out the | | | | back to make other tests to see the result. |
| catheter, and allowing the infant to urinate the | | | | It is difficult for children to do these tests |
| dye back out. During the procedure x-rays are | | | | because they are not funny, but these can help |
| taken. If any structural problem exists can be | | | | to discover the problems which can be treated. |