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Diagnosing and Treating Vesicoureteral Reflux

Intravenous Pyelogram
An intravenous pyelogram is a test that examines the whole urinary tract. A liquid that can be seen on x-rays is injected into a vein and travels into the kidneys and bladder, revealing possible obstructions.
 
Nuclear Scans
These tests use radioactive materials that are usually injected into a vein to show how well the kidneys work, the shape of the kidneys, and whether urine empties from the kidneys in a normal way. Each kind of nuclear scan will provide different information about the kidneys and bladder. Nuclear scans expose a child to about the same amount of radiation as a conventional x-ray.
 
Computed Tomography (CT) Scans and Magnetic Resonance Imaging (MRI)
These tests provide 3-D images and cross-sections of the bladder and kidneys. With a typical CT scan or MRI machine, the child will need to lie on a table that slides inside a tunnel where the images are taken. If the child's infection is complicated or difficult to see in other image tests, a CT scan or MRI can provide clearer, more detailed images to help the doctor understand the problem.
 

Treatments for Vesicoureteral Reflux

The goal for treatment of this condition is to prevent any kidney damage from occurring. Infections should be treated with antibiotics to prevent the infection from moving into the kidneys. Antibiotic therapy usually corrects reflux caused by infection.
 
Surgery, such as reimplantation of the ureters, may be needed to correct primary vesicoureteral reflux. During this surgery, the doctor will reposition the connection between the ureter and the bladder so that urine will not back up into the ureters and kidneys.
 
In recent years, doctors have treated some cases of vesicoureteral reflux by injecting collagen, or a similar substance, into the bladder wall, just below the opening where the ureter joins the bladder. This injection creates a kind of valve that keeps urine from flowing back into the ureter. The injection is delivered to the inside of the bladder through a catheter passed through the urethra, so there is no need for a surgical incision.
 
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