vesico ureteric reflux is one of the most high yield topic from pediatrics for pg entrance.....explanation has been given in brief

1. - DR.AKIF A.B
STEP TO PG-MD/MS - DR.AKIF A.B

2. STEP TO PG-MD/MS - DR.AKIF A.B
-Retrograde flow of urine from bladder
to ureter and renal pelvis.
-MC Cause of Recurrent UTIs in
children
-MC in females
-Present since birth but symptoms
appears at 2-3 yrs of age
-Complications:
1) Renal Scarring
2) Hypertension
3) Pyelonephritis
4) Cystitis

3. STEP TO PG-MD/MS - DR.AKIF A.B
Divides vesicoureteric reflux according to the height of reflux up the ureters
and degree of dilatation of the ureters:
VESICOURETERIC REFLUX (VUR)
GRADING
grade 1 reflux limited to the ureter
grade 2 reflux up to the renal pelvis
grade 3 mild dilatation of ureter and pelvicalyceal system
grade 4 tortuous ureter with moderate dilatation
blunting of fornices but preserved papillary impressions
grade 5 tortuous ureter with severe dilatation of ureter and
pelvicalyceal system
loss of fornices and papillary impressions

4. - IOC is = Micturating Cystourethrogram

5. STEP TO PG-MD/MS - DR.AKIF A.B
grade 1 reflux limited to the ureter
Grade I TREATMENT
Antibiotic Prophylaxis and follow up

6. STEP TO PG-MD/MS - DR.AKIF A.B
grade 2 reflux
up to the
renal
pelvis
Grade II TREATMENT
Antibiotic Prophylaxis and follow up

7. Grade 3 mild dilatation of ureter and pelvicalyceal system
STEP TO PG-MD/MS - DR.AKIF A.B

8. STEP TO PG-MD/MS - DR.AKIF A.B
Grade 4 tortuous ureter with moderate dilatation
blunting of fornices but preserved papillary
impressions

9. STEP TO PG-MD/MS - DR.AKIF A.B
Grade 5 tortuous ureter with severe dilatation of ureter and
pelvicalyceal system
loss of fornices and papillary impressions

10. Grade I & II
Antibiotic Prophylaxis and follow up
Grade III & IV
Age 0-5yrs :Antibiotic Prophylaxis and follow up
>5yrs : Unilateral : Antibiotic Prophylaxis and follow up
Bilateral : Surgery
Age < 1year Antibiotic Prophylaxis and follow up
1-5yrs Unilateral : Antibiotic Prophylaxis and
follow up
Bilateral : Surgery
> 5yrs Surgery
GRADE V
STEP TO PG-MD/MS - DR.AKIF A.B

11. Reimplantation of Ureter
If renal scarring is present at any
grade and if age is >1 year : Surgery
should be done
STEP TO PG-MD/MS - DR.AKIF A.B

12. STEP TO PG-MD/MS - DR.AKIF A.B

13. STEP TO PG-MD/MS - DR.AKIF A.B