What to know about VUR surgery

Vesicoureteral Kidney Reflux Surgery – A Simple Explanation

What is VUR Surgery?

The goal of vesicoureteral kidney reflux surgery is to repair a defect in the valve between your child’s bladder and affected ureters. When there is a defect in this value, it is unable to close and prevent urine from flowing backwards into the kidneys. This is called vesicoureteral reflux (VUR).

VUR is a condition in which urine from the bladder backs up to the ureters. The ureters are the tubes that carry urine from the kidneys down to the bladder. Sometimes when a child has VUR, urine can flow all the way back up into the kidney.

Vesicoureteral kidney reflux surgery, also called ureteral reimplantation, is performed to correct this condition and prevent further occurrences of VUR.

Surgeons use a few different techniques to perform this procedure. However, in general, this procedure is typically done using general anesthesia and an require overnight stay in a hospital. A cut will be made in your child’s lower belly, and the surgeon will fix the flap-valve attachment of the ureter to the bladder.

This should prevent further instances of VUR from happening again. No artificial materials are inserted into your child during this procedure.

What to Expect After Surgery

In most cases, your physician will prescribe antibiotics for a specified period of time. Your child may then require annual kidney ultrasounds to make sure a blockage is not present.

If your child has any kidney scarring resulting from VUR, your physician may suggest that he or she have their blood pressure checked each year.

Urinary tract infections can still occur after vesicoureteral kidney reflux surgery, but they are normally confined to the bladder.

Potential Complications1

Fortunately, vesicoureteral/kidney reflux surgery is a low-risk procedure for children with overall good health. Common potential complications that occur in 1-2% of patients include blockage (obstruction) of the ureter(s) or persistent reflux.

Blockage problems may be temporary, but in some cases the kidney may need to be drained with a tube that is inserted in the side or through the bladder.

In rare instances, an additional vesicoureteral/kidney reflux surgery may need to be performed to treat a blockage or persistent reflux.

Other rare complications can include infection of the surgical incision and bleeding. To prevent rare occurrences of lung infection, your child will be encouraged to take deep breaths and cough following his or her procedure.

Deflux as an Alternative to Surgery

In comparison to VUR surgery (ureteral reimplantation), endoscopic treatment with Deflux offers major advantages to patients and parents.2 The procedure takes less than 15 minutes and is performed in an outpatient setting.3 Deflux has greater patient convenience, less pain and reduced cost in comparison to surgery and antibiotics.2 A study showed that both patients and parents saw injection therapy as the least bothersome aspect of VUR treatment followed by antibiotics and VCUG testing.4  

Deflux Recovery  vs. Surgery Recovery

  • With Deflux, children are able to return to normal activities the next day3 vs a prolonged hospital stay with surgery2 
  • Deflux procedure is considered minimally invasive with minimal post-operative pain and no need for urinary catheter4
  • Surgical reimplant generally requires hospitalization to monitor for post-operative pain and temporarily drain the bladder.4

After the procedure, your doctor will determine what type of follow-up is needed and if additional treatment is required. 

Locate a pediatric urologist near you.

References:
  1. Beaumont Health. Vesicoureteral Reflux (VUR). Available at: https://www.beaumont.org/conditions/vesicoureteral-reflux. Accessed November 1, 2019.
  2. Ogan K, Pohl HG, Carlson D, et al. Parental preferences in the management of vesicoureteral reflux. J Urol. 2001;166(1):240-243.
  3. Cerwinka WH, Scherz HC, Kirsch AJ. Endoscopic treatment of vesicoureteral reflux with dextranomer/hyaluronic acid in children. Advances in Urology. 2008; 1-7.
  4. Sung J, Skoog S. Surgical management of vesicoureteral reflux in children. Pediatr Nephrol. 2012;27:551-561.