Children are a continuum of life and as such they should be cared
for and should be treated and treated
more when they have health problems.
Dr. Artan Koni, a specialist in the field of urology, explains in detail one of the most common pathologies in children with recurrent urinary tract infections.
-Dr Koni, can you make a medical prescription of what is urinary reflux, given that it is a problem that is often encountered or not?
– Yes, it is true, inflammation is a congenital pathology that is often encountered in the population. Some of these pass by themselves within the first year of life, never causing children urinary tract infections. Another part does not go away on its own and appears in the form of frequent urinary infections. A relatively small proportion of refluxes worsen over the years, fueled by other urinary tract problems. Urinary tract infections are treated with antibiotics, but frequent infections gradually damage the kidney. Therefore, in the case of frequent urinary infections, treatment with antibiotics alone is not enough. Kidney damage comes gradually, does not happen immediately, so this problem does not get too noticeable. But frequent urinary infections are the main cause of renal insufficiency in our country.
– How is this problem diagnosed?
– These children can be diagnosed in several ways, depending on their clinical condition. Visceral cystouretrography (VCU) is the most important examination in cases of urinary reflux. Although important, VCU is an invasive examination and can be overlooked in individual patients. So not all children have to undergo this examination, it all depends on the clinical condition of the child. Ultrasonography (eco) is another very important examination, not only for establishing the diagnosis but also for the continuous follow up of children. If the kidneys or urethra are enlarged, consult a pediatric urologist to rule out urinary reflux. Renal x-ray is another important examination which gives us information about kidney damage. In cases where the kidneys have started to become damaged, reflux treatment is also done more invasively. After age 1, kidney damage is irreversible, therefore urinary reflux is a problem that needs to be addressed.
– … and how is urinary reflux treated?
-There are several ways to treat urinary reflux, which is based on the condition of the child and of course talking to parents. In cases of mild reflux and no frequent urinary tract infections, tracking the baby can be a solution, because part of the reflux passes by itself.
– How to take antibiotics in children?
– Reduced dose antibiotics are important in children with frequent urinary tract infections, as preventing infections means preventing kidney damage. In cases of severe reflux, reflux surgery becomes necessary. Endoscopic surgery is preferred in recent years because not only is it a short operation but it also has no open surgery problems.
– Is surgery the most effective in cases of reflux?
– Endoscopic surgery is not effective in all cases of reflux, so the choice of open or closed surgery depends on the clinical condition of the child, discussing it with his parents as well. Open surgery solves the reflux problem and has few post-operative complications. However, this type of surgery is preferable for children with severe urinary reflux.
-Can the child suffering from this pathology constantly be followed?
-Continuous follow-up of the baby is the most important thing in cases of urinary reflux, because the reflux can change over time, for better or for worse. Different ways of treatment can be discussed with the pediatric urologist whenever the child’s clinical condition changes. Frequent urinary tract infections in children should be a bell to any parent, as urinary reflux is a hidden illness and gives no signs but damages the kidneys over time.
