Medical or Non-Surgical Treatment
Often reflux will go away with time. The lower the grade of reflux, the more likely it is to go away. The average age for this to happen is 5 to 6 years. The goal of medical or non-surgical treatment is to prevent UTI and kidney damage while the child grows. Reflux improves in many children because the junction between the bladder and the ureter gets longer with age.
This treatment involves:
- Encouraging the child to use the restroom regularly
- Checking that the child has regular stools bowel training
- Prescribing low doses of a preventive antibiotic to avoid a UTI
- Trying other drugs if the child is having trouble with bladder control
The child is seen in the office from time to time for a physical exam and urine is checked for infection. X-ray studies of the bladder and/or kidneys can also be done to check the status of the reflux and growth of the kidneys.
The goal of surgery is to cure reflux and avoid the risks of continued reflux. Surgery is most often done using general anesthesia. The surgeon makes a cut in the lower belly, and fixes the flap-valve attachment of the ureter to the bladder. This should prevent reflux from occurring. No artificial material is used and many techniques work well.
In endoscopic surgery (less invasive), the surgeon inserts a tool called a cystoscope into the urethral opening to see inside the bladder. A substance is then injected into the area where the ureter enters the bladder to try to fix the reflux. This requires the use of general anesthesia but in most cases it can be done on an outpatient basis. The rate of success compared to regular surgery depends on the particular case.
If surgery is necessary, the urologist will discuss the different options with the family.