Preventing damage from vr part 2 of 2 by dr dix poppas
Pediatric urologist Dr. Dix Poppas, who was recently selected as one of New York Magazine’s Best Doctors, continues answering questions about vesicoureteral reflux (VR).
Published on: Mar 4, 2016
Transcripts - Preventing damage from vr part 2 of 2 by dr dix poppas
By Dr. Dix Poppas
Pediatric urologist Dr. Dix Poppas, whowas recently selected as one of New YorkMagazine’s Best Doctors, continuesanswering questions about vesicoureteralreflux (VR).
Question: What complications arise when a child hasVR?Dr. Poppas: When a child suffers from VR, smallamounts of urine remain in the urinary tract for verylong periods. Bacteria have the chance to grow in theurine, and the children develop urinary tract infections.A urinary tract infection can cause additionalcomplications in a child with VR, because the bacteriacan easily move into the kidneys when urine refluxes.This can cause a kidney infection and permanentscarring, which leads to high blood pressure andkidney failure later in life.
Question: What steps do doctors take to prevent kidney damage inchildren diagnosed with VR?Dr. Poppas: In the past, the standard treatment was to treat the childaggressively with antibiotics to prevent infection and then wait for thestructural abnormalities to correct themselves. However, recentstudies have shown that prophylactic antibiotics are not effective atpreventing kidney damage. In addition, minimally invasiveapproaches to correcting VR using an extravesical approach havereduced the risks of surgical correction. Research is suggesting that,with the new techniques, early correction may be safer than waitingfor the condition to heal on its own. Ultimately, doctors treat eachchild as an individual case. Family history, the frequency andseverity of the child’s urinary tract infections, and other health issuesall help the doctors decide which course of treatment provides thebest outcomes.