My 2 month old son was diagnosed after having a VCUG as having a Grade 3 reflux in his left ureter. How severe is a Grade 3 reflux?
Answer -------------------
Reflux of uringe from the blader to the ureter (the tube leading from the kidney to the bladder) and renal pelvis (the urine collecting portion of the kidney) results from incompetence of the valves which are located in the ureter where it attaches to the bladder. The condition can be harmful to the kidneys because it exposes the kidney to high urine pressure during urination, and may allow bacteria to pass from the bladder to the kidneys. Primary reflux from the bladder to the kidney (vesicoureteral reflux) may occur as a congenital abnormality. In Grade III reflux, the ureter is dilated from the bladder all the way up into the renal pelvis, where the urine is collected in the kidney. Some lower grades of v-u reflux may improve spontaneously, but Grade III is serious enough that the chances of sppontaneous disappearance decrease to about 15%. A 2 month old with Grade III should be followed closely by the child's pediatrician and also, hopefully, by a pediatric urologist for appropriate surgical intervention, if necessary. --
Roger A. Forden, M.D.
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