Materiały źródłowe

• #1 Vesicoureteral Reflux (VUR): Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/5995-vesicoureteral-reflux

  Vesicoureteral reflux (VUR) is a condition where pee (urine) flows in the wrong direction. Instead of flowing from your kidneys, down into your ureters and bladder where it stays until you pee, your pee flows backward from your bladder. […] In VUR, pee flows back or refluxes from your bladder into one or both of your ureters and, in some cases, to one or both kidneys. It happens most often due to an issue that prevents the one-way valve from functioning as it should. […] Treatment for VUR depends on the severity of your child’s symptoms, age and other factors. Mild cases may not need treatment and some children outgrow VUR. But some children need surgery or medication to treat VUR so it doesn’t cause kidney damage. […] Managing VUR requires the help of a healthcare provider. Treatment options depend on your child’s age, symptoms, type of VUR and its severity. Treatments include antibiotics and other medications, an injectable dissolvable bulking agent, short-term catheterization and surgery.

• #2 Vesicoureteral reflux – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/vesicoureteral-reflux/symptoms-causes/syc-20378819

  Vesicoureteral (ves-ih-koe-yoo-REE-tur-ul) reflux means that some urine flows in the wrong direction once it reaches the bladder. It flows back up tubes called ureters that connect the kidneys to the bladder. Typically, urine flows from the kidneys through the ureters down to the bladder. It’s not supposed to flow back up. […] With vesicoureteral reflux, urine can carry germs from the bladder up to the kidneys. That raises the risk of urinary tract infections (UTIs). UTIs can happen in any of the organs that make urine and remove it from the body. These infections can cause symptoms such as a strong need to urinate and pain while urinating. Without treatment, UTIs can lead to kidney damage. […] Some children who are born with vesicoureteral reflux outgrow it. Others need treatment such as medicine or surgery. The goal of treatment is to prevent kidney damage and more UTIs.

• #3 Vesicoureteral Reflux (VUR) | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/vesicoureteral-reflux-vur

  Vesicoureteral reflux (VUR) is the result of abnormal formation of the normal valve between the kidney and bladder. This valve ensures that urine travels one way from the kidney to the bladder. If your child has VUR, the urine does move backward into the ureters and kidney. Some children only have mild VUR, while others have large amounts of urine moving backward into their kidneys. […] Although VUR by itself is not usually painful, VUR can become a problem if the child develops a urinary tract infection (UTI) in the bladder. With this type of infection, the bacteria are carried backward from the bladder to the kidneys, and this can result in serious infection and possibly damage to the kidneys. […] The Boston Childrens Hospital Department of Urology team takes a conservative approach to VUR. Most children will outgrow their VUR on their own, and we give them a chance to do just that.

• #4 Vesicoureteral Reflux | Northwestern Medicine

  https://www.nm.org/conditions-and-care-areas/urology/vesicoureteral-reflux

  VUR happens mostly in infants and young children. […] The Northwestern Medicine Congenital Urology Program provides comprehensive treatment and care for patients with VUR. […] Treatments for VUR depend on: […] Treatments can include antibiotics, surgery, or minimally invasive injections into the bladder.

• #5 Vesicoureteral Reflux Treatment & Management: Approach Considerations, Active Surveillance, Medical Care

  https://emedicine.medscape.com/article/439403-treatment

  Clinical management of vesicoureteral reflux (VUR) is complex and should be individualized. The main health concern in patients with VUR is the occurrence of febrile urinary tract infection (UTI) or pyelonephritis, which may lead to renal scarring, hypertension, and renal insufficiency. On the other hand, VUR has a high rate of spontaneous resolution, especially in young patients and with low-grade VUR. The goals of treatment are to minimize over-treatment in patients with low risk of UTI and to prevent renal scarring. […] The philosophy of medical management is based on the knowledge that low-grade reflux resolves spontaneously and sterile reflux does not damage the kidney. Medical management involves the following: administering long-term suppressive antibiotics, correcting the underlying voiding dysfunction (if present), conducting follow-up radiographic studies (eg, voiding cystourethrography [VCUG], nuclear cystography, dimercaptosuccinic acid [DMSA] scan) at regular intervals.

• #6 Vesicoureteral Reflux | Children’s Hospital Pittsburgh

  https://www.chp.edu/our-services/urology/conditions/vesicoureteral-reflux

  Reflux of urine is one of the more common reasons that children are referred to a pediatric urologist. […] Reflux can lead to kidney damage. Refluxing urine can carry bacteria to the kidney, where it can establish a kidney infection. Children with reflux of urine are much more likely to have kidney infection than children who do not have reflux. […] It is important in children with reflux to prevent kidney infections. This is achieved in three ways. In most children, prophylactic antibiotics are given. […] The third method of preventing infections involves improving the way that your child voids. […] For most children, prophylactic antibiotics are given on a daily basis. […] Surgery for reflux is highly successful and carries relatively little risk. […] In summary, vesicoureteral reflux is a relatively common disease which can be benign if treated appropriately. It can also have significant consequences if ignored. Most children will be cured with a few years of antibiotic prophylaxis, treatment of voiding dysfunction, surgery or a combination.

• #7 Vesicoureteral Reflux (VUR) – Causes, Symptoms, Treatments, and Where To Get Help

  https://www.webmd.com/children/vesicoureteral-reflux

  Vesicoureteral reflux (VUR) is when the flow of urine goes the wrong way. This condition is more common among infants and young children. […] VUR can also affect adults and older children. […] If you or your child have VUR, your doctor will give you a number score that ranges from 1 to 3, or 1 to 5, depending on what kind of test was taken. The higher the number, the more severe the VUR. […] Your treatment will depend on that score as well as your overall health. The lower the score is, the more likely the reflux will go away on its own. […] This is why your doctor may take a wait-and-see approach. Children often outgrow VUR as the valve between their bladder and ureter gets longer with age. […] If youre a parent of a child with VUR, try to get them to use the bathroom regularly. Other tips include:

• #8 Vesicoureteral Reflux (VUR) in Children

  https://www.nationwidechildrens.org/conditions/health-library/vesicoureteral-reflux-vur-in-children

  Vesicoureteral reflux (VUR) is a condition where urine in the bladder flows in the wrong direction. It goes up into the tubes (ureters) that lead to the kidneys. It often flows all the way back up to the kidneys. […] The ureters have a 1-way valve system that normally stops urine from flowing back up to the kidneys. When a child has VUR, this valve system doesnt work. Urine can then flow backward (reflux) into the ureters and may enter the kidneys. […] Treatment will depend on your childs symptoms, age, and general health. It will also depend on how bad the condition is. […] VUR can be mild or more serious. It can cause mild reflux, when urine backs up only a short distance in the ureters. Or it can cause severe reflux leading to kidney infections and lifelong (permanent) kidney damage. Your child’s healthcare provider may assign a grade from 1 to 5 to show the degree of reflux. The higher the grade, the more severe the reflux.

• #9 Pediatric Vesicoureteral Reflux – Conditions and Treatments | Children’s National Hospital

  https://www.childrensnational.org/get-care/health-library/vesicoureteral-reflux

  Vesicoureteral reflux (VUR) occurs when urine in the bladder flows back into the ureters and kidneys. […] A child who has vesicoureteral reflux is at risk for developing recurrent kidney infections, which, over time, can cause damage and scarring to the kidneys. […] Your child’s doctor may assign a grading system (ranging from 1-5) to indicate the degree of reflux. The higher the grade, the more severe the reflux. […] Most children who have grade 1 through 3 VUR do not need any type of intense therapy. The reflux resolves on its own over time, usually within five years. Children who develop frequent fevers or infections may require ongoing preventive antibiotic therapy and periodic urine tests. […] Preventive antibiotics have been shown to stop urinary infections in some cases and pose little risk of problems.

• #10 Vesicoureteral Reflux (VUR) | Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/v/vesicoureteral-reflux

  Vesicoureteral reflux (VUR) is a condition in which urine from the bladder is able to flow back up into the ureter and kidney. […] VUR becomes a problem when the urine in the bladder gets infected. The infected urine travels backward to the kidney. This can cause a kidney infection. Kidney infections lead to kidney damage. […] Options for treating VUR depend on your specific child and on the doctor. […] How VUR is managed, depends on the grade of reflux. This is determined by the VCUG. The frequency of UTIs, the presence and progression of any kidney damage, and the opinion of the parent are also considered. […] For grades I-III there is a good chance that the reflux will go away as the child grows and the bladder matures. These children are given low-dose antibiotics daily. This will suppress bacteria from growing. Occasional blood tests and urine cultures may be ordered.

• #11 8 Vesicoureteral Reflux (VUR) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/vesicoureteral-reflux-vur-nursing-care-plans/

  Use this nursing care plan and management guide to help care for patients with Vesicoureteral Reflux (VUR). Enhance your understanding of nursing assessment, interventions, goals, and nursing diagnosis, all specifically tailored to address the unique needs of individuals facing Vesicoureteral Reflux (VUR). […] Treatment of vesicoureteral reflux (VUR) is based on its severity. Nursing care planning goals for a patient with vesicoureteral reflux (VUR) may include relief of pain and discomfort, prevention of infection and trauma, and increased knowledge of the surgical procedure, expected outcomes, and postoperative care. Nurses also work to support the patients emotional well-being and provide education on self-care and prevention of future kidney damage. […] The following are the nursing priorities for patients with vesicoureteral reflux (VUR): Risk of urinary tract infection (UTI). Preventing and managing UTIs is a priority to prevent complications. Renal function and preservation. Monitoring renal function and implementing interventions to preserve renal health are essential. Detection and management of reflux grade. Identifying the grade of reflux through diagnostic tests and imaging is necessary for appropriate management. Prevention of renal scarring. Preventing renal scarring through effective management and prevention of UTIs is important to preserve renal function. Management of voiding dysfunction. Addressing voiding dysfunction, such as incomplete bladder emptying or dysfunctional voiding patterns, can help reduce the risk of UTIs and reflux episodes. Education and support for patients and caregivers. Empowering patients and caregivers with knowledge and resources improves adherence to treatment plans and reduces the risk of complications. Surgical intervention consideration. Assessing the need for surgical intervention and considering the appropriate timing and type of surgical procedure is a priority. Psychosocial support. Providing psychosocial support, addressing concerns, and ensuring their emotional well-being is an important aspect of care.

• #12 8 Vesicoureteral Reflux (VUR) Nursing Care Plans | Nursing care plan, Nursing care, Best nursing schools

  https://in.pinterest.com/pin/8-vesicoureteral-reflux-vur-nursing-care-plans–169870217179656358/

  Nursing care planning goals for a patient with vesicoureteral reflux (VUR) may include relief of pain and discomfort, prevention of infection and trauma, and increased knowledge of the surgical procedure, expected outcomes, and postoperative care.

• #13 8 Vesicoureteral Reflux (VUR) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/vesicoureteral-reflux-vur-nursing-care-plans/

  Use this nursing care plan and management guide to help care for patients with Vesicoureteral Reflux (VUR). Enhance your understanding of nursing assessment, interventions, goals, and nursing diagnosis, all specifically tailored to address the unique needs of individuals facing Vesicoureteral Reflux (VUR). […] Treatment of vesicoureteral reflux (VUR) is based on its severity. Nursing care planning goals for a patient with vesicoureteral reflux (VUR) may include relief of pain and discomfort, prevention of infection and trauma, and increased knowledge of the surgical procedure, expected outcomes, and postoperative care. Nurses also work to support the patients emotional well-being and provide education on self-care and prevention of future kidney damage. […] The following are the nursing priorities for patients with vesicoureteral reflux (VUR): Risk of urinary tract infection (UTI). Preventing and managing UTIs is a priority to prevent complications. Renal function and preservation. Monitoring renal function and implementing interventions to preserve renal health are essential. Detection and management of reflux grade. Identifying the grade of reflux through diagnostic tests and imaging is necessary for appropriate management. Prevention of renal scarring. Preventing renal scarring through effective management and prevention of UTIs is important to preserve renal function. Management of voiding dysfunction. Addressing voiding dysfunction, such as incomplete bladder emptying or dysfunctional voiding patterns, can help reduce the risk of UTIs and reflux episodes. Education and support for patients and caregivers. Empowering patients and caregivers with knowledge and resources improves adherence to treatment plans and reduces the risk of complications. Surgical intervention consideration. Assessing the need for surgical intervention and considering the appropriate timing and type of surgical procedure is a priority. Psychosocial support. Providing psychosocial support, addressing concerns, and ensuring their emotional well-being is an important aspect of care.

• #14 Nurseslabs – ✨ NEW CARE PLAN ✨ Vesicoureteral reflux…FacebookShared with Public

  https://www.facebook.com/nurseslabs/posts/-new-care-plan-vesicoureteral-reflux-vur-is-the-abnormal-backflow-of-urine-from-/10156206578143614/

  NEW CARE PLAN […] Vesicoureteral reflux (VUR) is the abnormal backflow of urine from the bladder into the ureter and up to the kidney. […] Nursing care planning goals for a patient with vesicoureteral reflux (VUR) may include relief of pain and discomfort, prevention of infection and trauma, and increased knowledge of the surgical procedure, expected outcomes, and postoperative care. […] The following are five (5) nursing care plans (NCP) for Vesicoureteral Reflux (VUR). […] Nursing care planning goals for a patient with vesicoureteral reflux (VUR) may include relief of pain and discomfort, prevention of infection and trauma, and increased knowledge of the surgical procedure, expected outcomes, and postoperative care.

• #15 8 Vesicoureteral Reflux (VUR) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/vesicoureteral-reflux-vur-nursing-care-plans/

  Use this nursing care plan and management guide to help care for patients with Vesicoureteral Reflux (VUR). Enhance your understanding of nursing assessment, interventions, goals, and nursing diagnosis, all specifically tailored to address the unique needs of individuals facing Vesicoureteral Reflux (VUR). […] Treatment of vesicoureteral reflux (VUR) is based on its severity. Nursing care planning goals for a patient with vesicoureteral reflux (VUR) may include relief of pain and discomfort, prevention of infection and trauma, and increased knowledge of the surgical procedure, expected outcomes, and postoperative care. Nurses also work to support the patients emotional well-being and provide education on self-care and prevention of future kidney damage. […] The following are the nursing priorities for patients with vesicoureteral reflux (VUR): Risk of urinary tract infection (UTI). Preventing and managing UTIs is a priority to prevent complications. Renal function and preservation. Monitoring renal function and implementing interventions to preserve renal health are essential. Detection and management of reflux grade. Identifying the grade of reflux through diagnostic tests and imaging is necessary for appropriate management. Prevention of renal scarring. Preventing renal scarring through effective management and prevention of UTIs is important to preserve renal function. Management of voiding dysfunction. Addressing voiding dysfunction, such as incomplete bladder emptying or dysfunctional voiding patterns, can help reduce the risk of UTIs and reflux episodes. Education and support for patients and caregivers. Empowering patients and caregivers with knowledge and resources improves adherence to treatment plans and reduces the risk of complications. Surgical intervention consideration. Assessing the need for surgical intervention and considering the appropriate timing and type of surgical procedure is a priority. Psychosocial support. Providing psychosocial support, addressing concerns, and ensuring their emotional well-being is an important aspect of care.

• #16 8 Vesicoureteral Reflux (VUR) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/vesicoureteral-reflux-vur-nursing-care-plans/

  Use this nursing care plan and management guide to help care for patients with Vesicoureteral Reflux (VUR). Enhance your understanding of nursing assessment, interventions, goals, and nursing diagnosis, all specifically tailored to address the unique needs of individuals facing Vesicoureteral Reflux (VUR). […] Treatment of vesicoureteral reflux (VUR) is based on its severity. Nursing care planning goals for a patient with vesicoureteral reflux (VUR) may include relief of pain and discomfort, prevention of infection and trauma, and increased knowledge of the surgical procedure, expected outcomes, and postoperative care. Nurses also work to support the patients emotional well-being and provide education on self-care and prevention of future kidney damage. […] The following are the nursing priorities for patients with vesicoureteral reflux (VUR): Risk of urinary tract infection (UTI). Preventing and managing UTIs is a priority to prevent complications. Renal function and preservation. Monitoring renal function and implementing interventions to preserve renal health are essential. Detection and management of reflux grade. Identifying the grade of reflux through diagnostic tests and imaging is necessary for appropriate management. Prevention of renal scarring. Preventing renal scarring through effective management and prevention of UTIs is important to preserve renal function. Management of voiding dysfunction. Addressing voiding dysfunction, such as incomplete bladder emptying or dysfunctional voiding patterns, can help reduce the risk of UTIs and reflux episodes. Education and support for patients and caregivers. Empowering patients and caregivers with knowledge and resources improves adherence to treatment plans and reduces the risk of complications. Surgical intervention consideration. Assessing the need for surgical intervention and considering the appropriate timing and type of surgical procedure is a priority. Psychosocial support. Providing psychosocial support, addressing concerns, and ensuring their emotional well-being is an important aspect of care.

• #17 8 Vesicoureteral Reflux (VUR) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/vesicoureteral-reflux-vur-nursing-care-plans/

  Therapeutic interventions and nursing actions for patients with vesicoureteral reflux (VUR) may include: […] Assess for the following subjective and objective data: Flank pain, Bladder spasms, Communication of pain descriptors, Crying, Ureteral edema from surgery, Irritability, restlessness, Withdrawal, Expressed apprehension and concern about surgery (ureteral reimplantation) and pre and postoperative procedures and care. […] Assess for factors related to the cause of vesicoureteral reflux (VUR): Surgery, Change in health status, change in environment (hospitalization for surgery), Lack of exposure to information about disorder, Internal factor of complications of surgical trauma, Catheter displacement, Urinary tract infection [acute, chronic or postoperative], Invasive postoperative drainage tubes (i.e., Silastic stents, urethral Foley or suprapubic tube).

• #18 8 Vesicoureteral Reflux (VUR) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/vesicoureteral-reflux-vur-nursing-care-plans/

  Therapeutic interventions and nursing actions for patients with vesicoureteral reflux (VUR) may include: […] Assess for the following subjective and objective data: Flank pain, Bladder spasms, Communication of pain descriptors, Crying, Ureteral edema from surgery, Irritability, restlessness, Withdrawal, Expressed apprehension and concern about surgery (ureteral reimplantation) and pre and postoperative procedures and care. […] Assess for factors related to the cause of vesicoureteral reflux (VUR): Surgery, Change in health status, change in environment (hospitalization for surgery), Lack of exposure to information about disorder, Internal factor of complications of surgical trauma, Catheter displacement, Urinary tract infection [acute, chronic or postoperative], Invasive postoperative drainage tubes (i.e., Silastic stents, urethral Foley or suprapubic tube).

• #19 Vesicoureteral Reflux and Nursing Interventions – 277 Words | Essay Example

  https://ivypanda.com/essays/vesicoureteral-reflux-disease-and-nursing-intervention/

  Vesicoureteral reflux (VUR) nursing care plans depend on the severity of the symptoms. […] Nursing intervention for VUR should be directed towards managing the discharge of the bladder, planning urination schedule, and monitoring any failures. […] The interventions for acute pain involve placing a patient in a comfortable position and avoiding excessive movements, maintaining catheters, and educating patients and their parents about pain. […] For infection prevention, nurses should constantly evaluate patient skin for changes, administer antibacterial therapy, change dressing timely, and provide catheter care. […] To assess the identified nursing interventions, the implementation process and care results should be considered.

• #20 8 Vesicoureteral Reflux (VUR) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/vesicoureteral-reflux-vur-nursing-care-plans/

  Therapeutic interventions and nursing actions for patients with vesicoureteral reflux (VUR) may include: […] Assess for the following subjective and objective data: Flank pain, Bladder spasms, Communication of pain descriptors, Crying, Ureteral edema from surgery, Irritability, restlessness, Withdrawal, Expressed apprehension and concern about surgery (ureteral reimplantation) and pre and postoperative procedures and care. […] Assess for factors related to the cause of vesicoureteral reflux (VUR): Surgery, Change in health status, change in environment (hospitalization for surgery), Lack of exposure to information about disorder, Internal factor of complications of surgical trauma, Catheter displacement, Urinary tract infection [acute, chronic or postoperative], Invasive postoperative drainage tubes (i.e., Silastic stents, urethral Foley or suprapubic tube).

• #21 8 Vesicoureteral Reflux (VUR) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/vesicoureteral-reflux-vur-nursing-care-plans/

  Therapeutic interventions and nursing actions for patients with vesicoureteral reflux (VUR) may include: […] Assess for the following subjective and objective data: Flank pain, Bladder spasms, Communication of pain descriptors, Crying, Ureteral edema from surgery, Irritability, restlessness, Withdrawal, Expressed apprehension and concern about surgery (ureteral reimplantation) and pre and postoperative procedures and care. […] Assess for factors related to the cause of vesicoureteral reflux (VUR): Surgery, Change in health status, change in environment (hospitalization for surgery), Lack of exposure to information about disorder, Internal factor of complications of surgical trauma, Catheter displacement, Urinary tract infection [acute, chronic or postoperative], Invasive postoperative drainage tubes (i.e., Silastic stents, urethral Foley or suprapubic tube).

• #22 Vesicoureteral Reflux and Nursing Interventions – 277 Words | Essay Example

  https://ivypanda.com/essays/vesicoureteral-reflux-disease-and-nursing-intervention/

  Vesicoureteral reflux (VUR) nursing care plans depend on the severity of the symptoms. […] Nursing intervention for VUR should be directed towards managing the discharge of the bladder, planning urination schedule, and monitoring any failures. […] The interventions for acute pain involve placing a patient in a comfortable position and avoiding excessive movements, maintaining catheters, and educating patients and their parents about pain. […] For infection prevention, nurses should constantly evaluate patient skin for changes, administer antibacterial therapy, change dressing timely, and provide catheter care. […] To assess the identified nursing interventions, the implementation process and care results should be considered.

• #23 Vesicoureteral Reflux and Nursing Interventions – 277 Words | Essay Example

  https://ivypanda.com/essays/vesicoureteral-reflux-disease-and-nursing-intervention/

  Vesicoureteral reflux (VUR) nursing care plans depend on the severity of the symptoms. […] Nursing intervention for VUR should be directed towards managing the discharge of the bladder, planning urination schedule, and monitoring any failures. […] The interventions for acute pain involve placing a patient in a comfortable position and avoiding excessive movements, maintaining catheters, and educating patients and their parents about pain. […] For infection prevention, nurses should constantly evaluate patient skin for changes, administer antibacterial therapy, change dressing timely, and provide catheter care. […] To assess the identified nursing interventions, the implementation process and care results should be considered.

• #24 Vesicoureteral Reflux and Nursing Interventions – 277 Words | Essay Example

  https://ivypanda.com/essays/vesicoureteral-reflux-disease-and-nursing-intervention/

  Vesicoureteral reflux (VUR) nursing care plans depend on the severity of the symptoms. […] Nursing intervention for VUR should be directed towards managing the discharge of the bladder, planning urination schedule, and monitoring any failures. […] The interventions for acute pain involve placing a patient in a comfortable position and avoiding excessive movements, maintaining catheters, and educating patients and their parents about pain. […] For infection prevention, nurses should constantly evaluate patient skin for changes, administer antibacterial therapy, change dressing timely, and provide catheter care. […] To assess the identified nursing interventions, the implementation process and care results should be considered.

• #25 Vesicoureteral Reflux (VUR) – Causes, Symptoms, Treatments, and Where To Get Help

  https://www.webmd.com/children/vesicoureteral-reflux

  Make sure your child takes the prescribed antibiotics, even if theyre used to prevent UTIs. […] Get your child to drink more water, as it helps flush out bacteria from the UTI. Avoid juices and soft drinks as they can irritate the bladder. […] Place a warm blanket or towel over your childs abdomen to ease pain or pressure.

• #26 8 Vesicoureteral Reflux (VUR) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/vesicoureteral-reflux-vur-nursing-care-plans/

  Goals and expected outcomes may include: The client will experience decreased pain. The client/parents will experience decreased anxiety. The parents will obtain information about child’s illness and treatment. The client will not experience injury as evidenced by absence of blood or clots in the urine, bladder is not distended and the client is able to urine after catheter removal. The client’s surgical incision will remain clean and dry without redness, edema, odor, or drainage. […] VUR can increase the risk of urinary tract infections and potentially lead to kidney damage. Minimizing injury risk and promoting safety are crucial considerations in the care of patients with vesicoureteral reflux (VUR). VUR condition can increase the risk of urinary tract infections (UTIs), renal damage, and other complications. Ensuring patient safety and minimizing injury risk are paramount to prevent further harm and optimize the well-being of individuals with VUR.

• #27 Vesicoureteral Reflux and Nursing Interventions – 277 Words | Essay Example

  https://ivypanda.com/essays/vesicoureteral-reflux-disease-and-nursing-intervention/

  Vesicoureteral reflux (VUR) nursing care plans depend on the severity of the symptoms. […] Nursing intervention for VUR should be directed towards managing the discharge of the bladder, planning urination schedule, and monitoring any failures. […] The interventions for acute pain involve placing a patient in a comfortable position and avoiding excessive movements, maintaining catheters, and educating patients and their parents about pain. […] For infection prevention, nurses should constantly evaluate patient skin for changes, administer antibacterial therapy, change dressing timely, and provide catheter care. […] To assess the identified nursing interventions, the implementation process and care results should be considered.

• #28

  https://www.healthychildren.org/English/health-issues/conditions/genitourinary-tract/Pages/Vesicoureteral-Reflux-in-Infants-Young-Children.aspx

  Continue to help your child with healthy bladder and bowel habits. All potty-trained children with VUR need to work on this to help prevent UTIs. […] It is also important that children completely empty their bladder every 2-3 hours when they are awake. Children should avoid holding their urine for long periods. This helps keep the bladder clean and prevents UTIs. […] Many children grow out of VUR over time, often by age 5. Finding VUR early and monitoring it closely with your child’s doctors–and getting treatment if needed–will help avoid any lasting problems.

• #29 Vesicoureteral Reflux and Nursing Interventions – 277 Words | Essay Example

  https://ivypanda.com/essays/vesicoureteral-reflux-disease-and-nursing-intervention/

  Vesicoureteral reflux (VUR) nursing care plans depend on the severity of the symptoms. […] Nursing intervention for VUR should be directed towards managing the discharge of the bladder, planning urination schedule, and monitoring any failures. […] The interventions for acute pain involve placing a patient in a comfortable position and avoiding excessive movements, maintaining catheters, and educating patients and their parents about pain. […] For infection prevention, nurses should constantly evaluate patient skin for changes, administer antibacterial therapy, change dressing timely, and provide catheter care. […] To assess the identified nursing interventions, the implementation process and care results should be considered.

• #30 8 Vesicoureteral Reflux (VUR) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/vesicoureteral-reflux-vur-nursing-care-plans/

  Medications play a crucial role in managing VUR, preventing urinary tract infections (UTIs), and preserving renal health. Pharmacologic support aims to alleviate symptoms, reduce the risk of complications, and optimize the overall well-being of patients with VUR. Its important to note that the use of medications in VUR management may vary depending on individual patient factors, such as age, severity of VUR, and presence of recurrent UTIs. The choice of medication and dosing should be determined by a healthcare professional based on the specific needs of each patient. […] Assessing and monitoring for potential complications in patients with vesicoureteral reflux (VUR) is essential for early detection, timely intervention, and appropriate management. It helps prevent kidney damage, detect urinary tract abnormalities, guide treatment decisions, and minimize the risk of long-term complications. […] Regular monitoring of laboratory values and performing diagnostic procedures is essential for assessing the severity of VUR, evaluating kidney function, detecting urinary tract abnormalities, and guiding appropriate management.

• #31 Pediatric Vesicoureteral Reflux Treatment & Management: Approach Considerations, Medical Care, Endoscopic Injection Therapy

  https://emedicine.medscape.com/article/1016439-treatment

  The treatment of children with VUR aims to prevent kidney infection, kidney damage, and the complications of kidney damage. Treatment options include surveillance, medical therapy, and surgical therapy. […] Medical treatment with prophylactic antibiotics remains the mainstay of initial management of VUR. […] Prophylaxis should be started once a child has completed treatment of the initial UTI and continued at least until imaging reveals VUR. […] Virtually all children with a new diagnosis of grade I-IV reflux, as well as some with grade V, are given a trial of medical treatment. […] Given that a substantial number of children experience spontaneous resolution of VUR (50-85% of cases with grade I-III), medical treatment spares this group the morbidity of surgery while protecting the kidneys from further damage.

• #32 Vesicoureteral reflux – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/vesicoureteral-reflux/

  Vesicoureteral reflux (VUR) is the retrograde flow of urine from the bladder into the ureter. […] Medical management with prophylactic antibiotics (e.g., trimethoprim-sulfamethoxazole, nitrofurantoin) and behavioral modification (timed micturition) has proven successful in treating and preventing complications. […] Patients with higher grades of primary VUR with ureteral dilation and hydronephrosis or with recurrent UTIs require endoscopic/surgical correction of the vesicoureteral junction. […] Conservative treatment includes long-term prophylactic antibiotics and correction of voiding dysfunction through behavior modification. […] Surgical treatment is indicated for VUR grade IV, bilateral grade III VUR, and worsening renal function despite prophylactic antibiotics. […] Subureteric transurethral injection (STING procedure) is a cystoscopy-guided injection that corrects the VUR.

• #33 8 Vesicoureteral Reflux (VUR) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/vesicoureteral-reflux-vur-nursing-care-plans/

  In VUR, the backward flow of urine can carry bacteria from the bladder into the ureters and kidneys, leading to UTIs. The longer urine stays in the urinary tract, the higher the risk of developing an infection. UTIs can cause inflammation and damage to the kidneys, potentially leading to more serious health problems if left untreated. Implementing effective infection control measures is crucial to prevent recurrent UTIs, reduce the risk of complications, and optimize the overall health of patients with VUR. […] Initiating health teachings and patient education are vital components of the care provided to patients with vesicoureteral reflux (VUR). Patient education plays a key role in empowering patients and their caregivers with knowledge and understanding about VUR, its management, and preventive measures. By providing comprehensive health teachings and patient education, healthcare professionals can enhance patients ability to actively participate in their own care, make informed decisions, and effectively manage the condition.

• #34 Vesicoureteral reflux – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/vesicoureteral-reflux/symptoms-causes/syc-20378819

  Call a healthcare professional right away if your child has any UTI symptoms, such as: A strong, persistent urge to urinate. A burning sensation when urinating. Pain in the stomach area, groin or side. Upset stomach or vomiting. […] Kidney damage is the main health concern, also called complication, that can happen with vesicoureteral reflux. The worse the reflux, the more serious the complications are likely to be. […] Complications may include: Kidney scarring. Without treatment, UTIs can lead to lasting damage to kidney tissue known as scarring. Extensive scarring may lead to high blood pressure and kidney failure.

• #35 Vesicoureteral Reflux (VUR) – Causes, Symptoms, Treatments, and Where To Get Help

  https://www.webmd.com/children/vesicoureteral-reflux

  Make sure your child takes the prescribed antibiotics, even if theyre used to prevent UTIs. […] Get your child to drink more water, as it helps flush out bacteria from the UTI. Avoid juices and soft drinks as they can irritate the bladder. […] Place a warm blanket or towel over your childs abdomen to ease pain or pressure.

• #36 Vesicoureteral Reflux (VUR) | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/vesicoureteral-reflux-vur

  Our main goal is to treat vesicoureteral reflux and prevent infections that might affect the kidneys and possibly cause kidney damage. Our specialists provide a comprehensive approach to the management of vesicoureteral reflux from initial diagnosis to treatment and follow-up care. […] Many children with VUR will outgrow the condition on their own. Therefore, we do not perform surgery as initial treatment in most children. Some children, however, will require surgery to correct VUR. The most common reasons for proceeding with surgical correction of VUR are repeated UTI with kidney involvement, failure of VUR to resolve on its own over time, or severe VUR that is very unlikely to resolve. […] During the open ureteral reimplantation, the surgeon makes an incision in the lower abdomen and exposes the bladder. The junction of the bladder and the ureter (the tube connecting the bladder to the kidney) is reconstructed to prevent urine from flowing backward up into the kidney. A catheter is left in the bladder to drain the urine for the first one to two days after surgery.

• #37 Vesicoureteral Reflux (VUR) | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/vesicoureteral-reflux-vur

  Our main goal is to treat vesicoureteral reflux and prevent infections that might affect the kidneys and possibly cause kidney damage. Our specialists provide a comprehensive approach to the management of vesicoureteral reflux from initial diagnosis to treatment and follow-up care. […] Many children with VUR will outgrow the condition on their own. Therefore, we do not perform surgery as initial treatment in most children. Some children, however, will require surgery to correct VUR. The most common reasons for proceeding with surgical correction of VUR are repeated UTI with kidney involvement, failure of VUR to resolve on its own over time, or severe VUR that is very unlikely to resolve. […] During the open ureteral reimplantation, the surgeon makes an incision in the lower abdomen and exposes the bladder. The junction of the bladder and the ureter (the tube connecting the bladder to the kidney) is reconstructed to prevent urine from flowing backward up into the kidney. A catheter is left in the bladder to drain the urine for the first one to two days after surgery.

• #38 8 Vesicoureteral Reflux (VUR) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/vesicoureteral-reflux-vur-nursing-care-plans/

  Goals and expected outcomes may include: The client will experience decreased pain. The client/parents will experience decreased anxiety. The parents will obtain information about child’s illness and treatment. The client will not experience injury as evidenced by absence of blood or clots in the urine, bladder is not distended and the client is able to urine after catheter removal. The client’s surgical incision will remain clean and dry without redness, edema, odor, or drainage. […] VUR can increase the risk of urinary tract infections and potentially lead to kidney damage. Minimizing injury risk and promoting safety are crucial considerations in the care of patients with vesicoureteral reflux (VUR). VUR condition can increase the risk of urinary tract infections (UTIs), renal damage, and other complications. Ensuring patient safety and minimizing injury risk are paramount to prevent further harm and optimize the well-being of individuals with VUR.

• #39 Vesicoureteral Reflux (VUR) | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/vesicoureteral-reflux-vur

  Surgical intervention: Children who have grade 4 and 5 reflux or who have had repeated UTIs with concerns of kidney scarring, may require surgical intervention to fix the reflux. […] Many factors should be considered when deciding about what treatment is best for your child: the severity of the reflux, whether the reflux is in one or both ureters, your child’s age and gender and the presence of kidney damage. We will thoroughly discuss all options with you and your child. […] Endoscopic surgery: This is usually an outpatient procedure under general anesthesia. During surgery a lighted tube, called a cystoscope, is inserted into the urethral opening to see inside the bladder no incisions are made. A substance, called Deflux, is injected into the area where the ureter enters the bladder. Deflux helps prevent urine from flowing back into the ureter.

• #40 Vesicoureteral Reflux (VUR) | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/vesicoureteral-reflux-vur

  Ureteral reimplant: Under general anesthesia and through a lower abdominal incision, the ureter is reimplanted where it joins the bladder. Ureteral reimplantation corrects the anatomical abnormality that allows urine to flow back into the ureter. At CHOP this procedure can be done through a minimally invasive surgery (MIS) using a laparoscopic or robotic approach. This involves only a few small incisions instead of a larger lower abdominal incision. The benefits of MIS include a faster recovery, smaller incisions and a less noticeable scar. Most children go home the day after surgery.

• #41 Vesicoureteral Reflux Treatment & Management: Approach Considerations, Active Surveillance, Medical Care

  https://emedicine.medscape.com/article/439403-treatment

  Continuous antibacterial prophylaxis decreases the incidence of pyelonephritis and subsequent renal scarring for low-to-moderate grades of reflux. Therefore, nonsurgical management is appropriate for mild-to-moderate VUR (ie, grades I-IV) in the absence of breakthrough infections or anatomic abnormalities, as discussed above. […] Surgery (ureteral reimplantation or ureteroneocystostomy) is the definitive method of correcting primary reflux, especially in the setting of anatomic abnormalities. […] Complications include the following: persistent, transient, contralateral reflux, postoperative ureteral obstruction, hematuria, urosepsis, anuria. […] Yearly ultrasonography helps to monitor renal growth, to detect hydronephrosis, and to evaluate bladder anatomy and voiding dynamics (filling and emptying). However, this is not mandatory, especially if the patient has not had evidence of febrile UTI and has had normal findings on initial ultrasonography.

• #42 Vesicoureteral Reflux (VUR) | Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/v/vesicoureteral-reflux

  The goals of surgery are to: Correct the reflux, Prevent pyelonephritis (kidney infection), Preserve renal function. […] After reflux surgery, there may be limits on physical activity. This will be based on what your surgeon decides. Voiding every two to three hours as well as drinking adequate fluids helps healing. Your child may return to school the day after surgery. […] Healthy bladder habits are vital. These include drinking an adequate amount of water and avoiding bladder irritants in the diet. Good perineal hygiene, even more so in girls, along with voiding every three to four hours, helps to prevent urinary tract infections.

• #43 Vesicoureteral Reflux | Conditions | UCSF Benioff Children’s Hospitals

  https://www.ucsfbenioffchildrens.org/conditions/vesicoureteral-reflux

  Surgery would be performed if your child has more severe reflux, fever-causing urinary tract infections despite being on antibiotics, and signs of kidney damage due to repeated infections. […] In the surgical procedure, the refluxing ureter is repositioned or re-implanted in the bladder wall. The end of the ureter is surrounded by bladder muscle in this new position in the bladder, which prevents urine from „backing up” or refluxing toward the bladder. […] Your child will be in the hospital for three to four days. After the surgery, your child will still need to take antibiotics daily until the bladder and ureter are healed. An ultrasound will be performed about a month after surgery and, depending on the case, a voiding cystourethrogram may be performed six months following surgery.

• #44 8 Vesicoureteral Reflux (VUR) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/vesicoureteral-reflux-vur-nursing-care-plans/

  Medications play a crucial role in managing VUR, preventing urinary tract infections (UTIs), and preserving renal health. Pharmacologic support aims to alleviate symptoms, reduce the risk of complications, and optimize the overall well-being of patients with VUR. Its important to note that the use of medications in VUR management may vary depending on individual patient factors, such as age, severity of VUR, and presence of recurrent UTIs. The choice of medication and dosing should be determined by a healthcare professional based on the specific needs of each patient. […] Assessing and monitoring for potential complications in patients with vesicoureteral reflux (VUR) is essential for early detection, timely intervention, and appropriate management. It helps prevent kidney damage, detect urinary tract abnormalities, guide treatment decisions, and minimize the risk of long-term complications. […] Regular monitoring of laboratory values and performing diagnostic procedures is essential for assessing the severity of VUR, evaluating kidney function, detecting urinary tract abnormalities, and guiding appropriate management.

• #45 8 Vesicoureteral Reflux (VUR) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/vesicoureteral-reflux-vur-nursing-care-plans/

  Goals and expected outcomes may include: The client will experience decreased pain. The client/parents will experience decreased anxiety. The parents will obtain information about child’s illness and treatment. The client will not experience injury as evidenced by absence of blood or clots in the urine, bladder is not distended and the client is able to urine after catheter removal. The client’s surgical incision will remain clean and dry without redness, edema, odor, or drainage. […] VUR can increase the risk of urinary tract infections and potentially lead to kidney damage. Minimizing injury risk and promoting safety are crucial considerations in the care of patients with vesicoureteral reflux (VUR). VUR condition can increase the risk of urinary tract infections (UTIs), renal damage, and other complications. Ensuring patient safety and minimizing injury risk are paramount to prevent further harm and optimize the well-being of individuals with VUR.

• #46 Vesicoureteral Reflux Treatment & Management: Approach Considerations, Active Surveillance, Medical Care

  https://emedicine.medscape.com/article/439403-treatment

  Continuous antibacterial prophylaxis decreases the incidence of pyelonephritis and subsequent renal scarring for low-to-moderate grades of reflux. Therefore, nonsurgical management is appropriate for mild-to-moderate VUR (ie, grades I-IV) in the absence of breakthrough infections or anatomic abnormalities, as discussed above. […] Surgery (ureteral reimplantation or ureteroneocystostomy) is the definitive method of correcting primary reflux, especially in the setting of anatomic abnormalities. […] Complications include the following: persistent, transient, contralateral reflux, postoperative ureteral obstruction, hematuria, urosepsis, anuria. […] Yearly ultrasonography helps to monitor renal growth, to detect hydronephrosis, and to evaluate bladder anatomy and voiding dynamics (filling and emptying). However, this is not mandatory, especially if the patient has not had evidence of febrile UTI and has had normal findings on initial ultrasonography.

• #47 Vesicoureteral Reflux Treatment & Management: Approach Considerations, Active Surveillance, Medical Care

  https://emedicine.medscape.com/article/439403-treatment

  Continuous antibacterial prophylaxis decreases the incidence of pyelonephritis and subsequent renal scarring for low-to-moderate grades of reflux. Therefore, nonsurgical management is appropriate for mild-to-moderate VUR (ie, grades I-IV) in the absence of breakthrough infections or anatomic abnormalities, as discussed above. […] Surgery (ureteral reimplantation or ureteroneocystostomy) is the definitive method of correcting primary reflux, especially in the setting of anatomic abnormalities. […] Complications include the following: persistent, transient, contralateral reflux, postoperative ureteral obstruction, hematuria, urosepsis, anuria. […] Yearly ultrasonography helps to monitor renal growth, to detect hydronephrosis, and to evaluate bladder anatomy and voiding dynamics (filling and emptying). However, this is not mandatory, especially if the patient has not had evidence of febrile UTI and has had normal findings on initial ultrasonography.

• #48 8 Vesicoureteral Reflux (VUR) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/vesicoureteral-reflux-vur-nursing-care-plans/

  Medications play a crucial role in managing VUR, preventing urinary tract infections (UTIs), and preserving renal health. Pharmacologic support aims to alleviate symptoms, reduce the risk of complications, and optimize the overall well-being of patients with VUR. Its important to note that the use of medications in VUR management may vary depending on individual patient factors, such as age, severity of VUR, and presence of recurrent UTIs. The choice of medication and dosing should be determined by a healthcare professional based on the specific needs of each patient. […] Assessing and monitoring for potential complications in patients with vesicoureteral reflux (VUR) is essential for early detection, timely intervention, and appropriate management. It helps prevent kidney damage, detect urinary tract abnormalities, guide treatment decisions, and minimize the risk of long-term complications. […] Regular monitoring of laboratory values and performing diagnostic procedures is essential for assessing the severity of VUR, evaluating kidney function, detecting urinary tract abnormalities, and guiding appropriate management.

• #49 Vesicoureteral Reflux Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/vesicoureteral-reflux-guideline

  Surgical intervention for VUR, including both open and endoscopic methods, may be used. Prospective randomized controlled trials have shown a reduction in the occurrence of febrile urinary tract infections in patients who have undergone open surgical correction of VUR as compared to those receiving continuous antibiotic prophylaxis. […] Following open surgical or endoscopic procedures for VUR, a renal ultrasound should be obtained to assess for obstruction. […] It is recommended that a plan be provided to the family/patient and the primary care physician regarding monitoring for the long-term potential issues related to VUR. […] The presence of VUR in neonates with a history of prenatal hydronephrosis can be confirmed by performing a VCUG or radionuclide cystography. […] In siblings of children with VUR, a voiding cystourethrogram or radionuclide cystogram is recommended if there is evidence of renal cortical abnormalities or renal size asymmetry on ultrasound or if there is a history of urinary tract infection in the sibling who has not been tested.

• #50 Pediatric Vesicoureteral Reflux Treatment & Management: Approach Considerations, Medical Care, Endoscopic Injection Therapy

  https://emedicine.medscape.com/article/1016439-treatment

  The importance of conscientious follow-up care during medical management cannot be overemphasized. Lack of compliance with medications or surveillance imaging may result in progression of reflux nephropathy and renal failure in children who are susceptible. […] The importance of aggressive bladder and bowel management for dysfunctional elimination cannot be overemphasized. […] Anticholinergic medication, in conjunction with timed voiding, may improve symptoms of dysfunctional voiding and reduces the risk of infection. […] Many of these patients benefit from some form of bladder training to achieve balanced, low-pressure voiding with coordinated relaxation of the external sphincter and pelvic floor. […] Good communication between the urologist and the primary care physician is essential for the effective management of VUR. This is especially true for children being treated medically, in whom regular follow-up care and prompt evaluation and treatment of breakthrough UTI are critical in preventing renal damage. […] Children whose VUR is being managed medically are regularly seen on an annual basis. Routine evaluation includes urinalysis and urine culture, appropriate imaging, and blood pressure measurement.

• #51 The Diagnosis and Treatment of Vesicoureteral Reflux: An Update

  https://openurologyandnephrologyjournal.com/VOLUME/8/PAGE/96/

  Vesicoureteral reflux [VUR] remains a common problem seen by pediatric providers. […] The goals of managing VUR include preventing future febrile urinary tract infections [FUTI], renal scarring, reflux nephropathy and hypertension. […] The elimination of bladder and bowel dysfunction [BBD] is an important management strategy to prevent further FUTIs, regardless of treatment choice. […] The latest AUA VUR guidelines recognize this concomitant relationship between VUR, UTIs, and BBD. […] Due to this comorbidity, the AUA recommends screening for symptoms indicative of BBD upon initial evaluation. […] The guidelines recommend treatment of BBD prior to any surgical treatment of VUR. […] A critical driving force in the management of VUR is the presence of UTI and in particular FUTI. […] The association of UTIs with BBD is due to several characteristics of the lower urinary tract with BBD that provides an ideal environment for the propagation of uropathic bacteria.

• #52 The Diagnosis and Treatment of Vesicoureteral Reflux: An Update

  https://openurologyandnephrologyjournal.com/VOLUME/8/PAGE/96/

  Management of BBD initially consists of behavioral modification [termed standard urotherapy] that entails education regarding the anatomy and function of the bladder, bowel and pelvic floor musculature. […] Continuous antibiotic prophylaxis [CAP] is recommended for those with concomitant BBD and VUR due to an increased risk of UTI. […] Open ureteral reimplantation can be quite successful in the treatment of VUR in children, regardless of the presence of BBD. […] The evaluation for BBD in toilet-trained patients with VUR and UTIs should routinely be performed, as successful BBD management promotes downgrading or elimination of VUR.

• #53

  https://www.healthychildren.org/English/health-issues/conditions/genitourinary-tract/Pages/Vesicoureteral-Reflux-in-Infants-Young-Children.aspx

  Continue to help your child with healthy bladder and bowel habits. All potty-trained children with VUR need to work on this to help prevent UTIs. […] It is also important that children completely empty their bladder every 2-3 hours when they are awake. Children should avoid holding their urine for long periods. This helps keep the bladder clean and prevents UTIs. […] Many children grow out of VUR over time, often by age 5. Finding VUR early and monitoring it closely with your child’s doctors–and getting treatment if needed–will help avoid any lasting problems.

• #54 UTI and Vesicoureteral Reflux | Penn State Health

  https://www.pennstatehealth.org/childrens/services-treatments/uti-vesicoureteral-reflux

  Evaluation may include a referral to pediatric urology and nephrology specialists at Penn State Health for expert diagnosis and care recommendations. You can also contact us to schedule an appointment with a Penn State Health specialist. […] Doctors will identify VUR and UTI and recommend treatment options. VUR can get better with age. If no infection is present, VUR may not require treatment other than close monitoring of symptoms through follow-up appointments. […] Outcomes are typically good with early, expert evaluation, care and follow-up. Families can help prevent problems by taking these and other measures as discussed by your childs doctor: Give children a high-fiber diet with plenty of fluids to prevent constipation, which increases UTI risk. […] Discourage children from trying to hold urine too long and aim for emptying the bladder every two to four hours while the child is awake.

• #55 8 Vesicoureteral Reflux (VUR) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/vesicoureteral-reflux-vur-nursing-care-plans/

  Use this nursing care plan and management guide to help care for patients with Vesicoureteral Reflux (VUR). Enhance your understanding of nursing assessment, interventions, goals, and nursing diagnosis, all specifically tailored to address the unique needs of individuals facing Vesicoureteral Reflux (VUR). […] Treatment of vesicoureteral reflux (VUR) is based on its severity. Nursing care planning goals for a patient with vesicoureteral reflux (VUR) may include relief of pain and discomfort, prevention of infection and trauma, and increased knowledge of the surgical procedure, expected outcomes, and postoperative care. Nurses also work to support the patients emotional well-being and provide education on self-care and prevention of future kidney damage. […] The following are the nursing priorities for patients with vesicoureteral reflux (VUR): Risk of urinary tract infection (UTI). Preventing and managing UTIs is a priority to prevent complications. Renal function and preservation. Monitoring renal function and implementing interventions to preserve renal health are essential. Detection and management of reflux grade. Identifying the grade of reflux through diagnostic tests and imaging is necessary for appropriate management. Prevention of renal scarring. Preventing renal scarring through effective management and prevention of UTIs is important to preserve renal function. Management of voiding dysfunction. Addressing voiding dysfunction, such as incomplete bladder emptying or dysfunctional voiding patterns, can help reduce the risk of UTIs and reflux episodes. Education and support for patients and caregivers. Empowering patients and caregivers with knowledge and resources improves adherence to treatment plans and reduces the risk of complications. Surgical intervention consideration. Assessing the need for surgical intervention and considering the appropriate timing and type of surgical procedure is a priority. Psychosocial support. Providing psychosocial support, addressing concerns, and ensuring their emotional well-being is an important aspect of care.

• #56 Learning About Vesicoureteral Reflux (VUR) in Newborns | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.learning-about-vesicoureteral-reflux-vur-in-newborns.abq4571

  Vesicoureteral reflux (VUR) is the backward flow of urine inside the body. Urine is made by the kidneys and is supposed to flow to the bladder through the ureters and then leave the body. But when it flows backward, from the bladder to the kidneys, it can cause bacteria to reach your baby’s kidneys. This could cause an infection or scarring. […] The hospital staff is well prepared to care for babies with this condition. They will do everything they can to help. If you need it, ask for support from friends and family. You can also ask the hospital staff about counseling and support. […] Follow-up care is a key part of your child’s treatment and safety. Be sure to make and go to all appointments, and call your doctor if your child is having problems. It’s also a good idea to know your child’s test results and keep a list of the medicines your child takes.

• #57 CE Activity | Vesicoureteral Reflux | Pharmacist

  https://www.statpearls.com/pharmacist/ce/activity/77957

  This activity highlights the crucial role of a collaborative interprofessional healthcare team, including urologists, surgeons, radiologists, nurses, pharmacists, and technologists, in delivering comprehensive care and assessing and enhancing treatment methods for patients with VUR. […] At the conclusion of this activity, the learner will be better able to: […] Apply patient education techniques to communicate the diagnosis, treatment options, and long-term implications of vesicoureteral reflux to caregivers. […] Collaborate with interprofessional healthcare providers to develop a holistic approach, optimize long-term outcomes, and minimize the risk of recurrence or complications.

• #58 CE Activity | Vesicoureteral Reflux | Pharmacist

  https://www.statpearls.com/pharmacist/ce/activity/77957

  This activity highlights the crucial role of a collaborative interprofessional healthcare team, including urologists, surgeons, radiologists, nurses, pharmacists, and technologists, in delivering comprehensive care and assessing and enhancing treatment methods for patients with VUR. […] At the conclusion of this activity, the learner will be better able to: […] Apply patient education techniques to communicate the diagnosis, treatment options, and long-term implications of vesicoureteral reflux to caregivers. […] Collaborate with interprofessional healthcare providers to develop a holistic approach, optimize long-term outcomes, and minimize the risk of recurrence or complications.

• #59 CE Activity | Vesicoureteral Reflux | Pharmacist

  https://www.statpearls.com/pharmacist/ce/activity/77957

  This activity highlights the crucial role of a collaborative interprofessional healthcare team, including urologists, surgeons, radiologists, nurses, pharmacists, and technologists, in delivering comprehensive care and assessing and enhancing treatment methods for patients with VUR. […] At the conclusion of this activity, the learner will be better able to: […] Apply patient education techniques to communicate the diagnosis, treatment options, and long-term implications of vesicoureteral reflux to caregivers. […] Collaborate with interprofessional healthcare providers to develop a holistic approach, optimize long-term outcomes, and minimize the risk of recurrence or complications.

• #60 Pediatric Vesicoureteral Reflux Treatment & Management: Approach Considerations, Medical Care, Endoscopic Injection Therapy

  https://emedicine.medscape.com/article/1016439-treatment

  The importance of conscientious follow-up care during medical management cannot be overemphasized. Lack of compliance with medications or surveillance imaging may result in progression of reflux nephropathy and renal failure in children who are susceptible. […] The importance of aggressive bladder and bowel management for dysfunctional elimination cannot be overemphasized. […] Anticholinergic medication, in conjunction with timed voiding, may improve symptoms of dysfunctional voiding and reduces the risk of infection. […] Many of these patients benefit from some form of bladder training to achieve balanced, low-pressure voiding with coordinated relaxation of the external sphincter and pelvic floor. […] Good communication between the urologist and the primary care physician is essential for the effective management of VUR. This is especially true for children being treated medically, in whom regular follow-up care and prompt evaluation and treatment of breakthrough UTI are critical in preventing renal damage. […] Children whose VUR is being managed medically are regularly seen on an annual basis. Routine evaluation includes urinalysis and urine culture, appropriate imaging, and blood pressure measurement.

• #61 New clinical evidence shifts approach to vesicoureteral reflux (VUR) care – CHOC Pediatrica

  https://care.choc.org/personalized-medicine-surgical-innovations-advance-pediatric-brain-tumor-care-2/

  While diagnosing patients with high-risk disease is important, it’s equally as important to minimize over-diagnosis of patients with low-risk disease who will likely remain asymptomatic with no long-term sequelae. […] We want to focus on finding the patients at the highest risk for long-term sequelae who truly require treatment to prevent further upper tract damage. […] Stratified treatment for VUR begins with the least-invasive option: expectant management with behavioral modifications to ensure healthy bowel and bladder habits. […] In children at intermediate or high risk, a low-dose daily antibiotic may be prescribed along with an intent focus on bowel and bladder management in the toilet-trained child. […] Surgical intervention, such as an open ureteral reimplant or endoscopic treatment with injection of Deflux® (a bulking agent to prevent urinary reflux) is also available.

• #62 Vesicoureteral Reflux Treatment & Management: Approach Considerations, Active Surveillance, Medical Care

  https://emedicine.medscape.com/article/439403-treatment

  Clinical management of vesicoureteral reflux (VUR) is complex and should be individualized. The main health concern in patients with VUR is the occurrence of febrile urinary tract infection (UTI) or pyelonephritis, which may lead to renal scarring, hypertension, and renal insufficiency. On the other hand, VUR has a high rate of spontaneous resolution, especially in young patients and with low-grade VUR. The goals of treatment are to minimize over-treatment in patients with low risk of UTI and to prevent renal scarring. […] The philosophy of medical management is based on the knowledge that low-grade reflux resolves spontaneously and sterile reflux does not damage the kidney. Medical management involves the following: administering long-term suppressive antibiotics, correcting the underlying voiding dysfunction (if present), conducting follow-up radiographic studies (eg, voiding cystourethrography [VCUG], nuclear cystography, dimercaptosuccinic acid [DMSA] scan) at regular intervals.

• #63 New clinical evidence shifts approach to vesicoureteral reflux (VUR) care – CHOC Pediatrica

  https://care.choc.org/personalized-medicine-surgical-innovations-advance-pediatric-brain-tumor-care-2/

  While diagnosing patients with high-risk disease is important, it’s equally as important to minimize over-diagnosis of patients with low-risk disease who will likely remain asymptomatic with no long-term sequelae. […] We want to focus on finding the patients at the highest risk for long-term sequelae who truly require treatment to prevent further upper tract damage. […] Stratified treatment for VUR begins with the least-invasive option: expectant management with behavioral modifications to ensure healthy bowel and bladder habits. […] In children at intermediate or high risk, a low-dose daily antibiotic may be prescribed along with an intent focus on bowel and bladder management in the toilet-trained child. […] Surgical intervention, such as an open ureteral reimplant or endoscopic treatment with injection of Deflux® (a bulking agent to prevent urinary reflux) is also available.

• #64 Vesicoureteral Reflux | Conditions | UCSF Benioff Children’s Hospitals

  https://www.ucsfbenioffchildrens.org/conditions/vesicoureteral-reflux

  Vesicoureteral reflux, or VUR, is treated either with medication or surgery, depending on the severity of the reflux, the child’s age, the number and severity of urinary tract infections and the amount of kidney damage seen on X-ray studies. […] Treatment always includes a low daily dose of antibiotics. These antibiotics are very specific for the urinary tract and have very few side effects. The goal is to prevent kidney infections until the reflux goes away or is corrected. The type of antibiotic we use will depend on your child’s age and allergies. […] Because many cases of reflux resolve on their own as the child grows, medical therapy may be all that’s needed. Medical therapy entails using antibiotics to prevent infection until the condition resolves, and monitoring your child to make sure it does resolve. […] Children receiving medical therapy will take a small dose of antibiotics every day. An ultrasound and cystogram will be done annually to assess the kidneys and see if the reflux has resolved. If the reflux persists for several years without improvement, surgery may be considered. If your child continues to have fever-causing urinary tract infections despite taking antibiotics, then surgery should be considered. Again, the goal is to prevent scarring or damage from a kidney infection.

• #65 Vesicoureteral Reflux (VUR) | UCSF Department of Urology

  https://urology.ucsf.edu/patient-care/children/additional/vesicoureteral-reflux

  Vesicoureteral reflux can resolve on its own. Therefore we conservatively manage patients with close follow-up to see if they can outgrow the vesicoureteral reflux on their own. […] For patient with higher grades of vesicoureteral reflux or a history of urinary tract infection we often give them a low dose of daily antibiotics (antibiotic prophylaxis) to help prevent urinary tract infection while we are awaiting resolution. […] Some children will eventually require surgery for vesicoureteral reflux. The most common reason for surgical intervention is if a child with vesicoureteral reflux has urinary tract infections despite antibiotic prophylaxis. […] There are two main surgical interventions for vesicoureteral reflux: ureteral reimplantation surgery (open repair) and endoscopic treatment.

• #66 Vesicoureteral Reflux (VUR) | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/vesicoureteral-reflux-vur

  Surgical intervention: Children who have grade 4 and 5 reflux or who have had repeated UTIs with concerns of kidney scarring, may require surgical intervention to fix the reflux. […] Many factors should be considered when deciding about what treatment is best for your child: the severity of the reflux, whether the reflux is in one or both ureters, your child’s age and gender and the presence of kidney damage. We will thoroughly discuss all options with you and your child. […] Endoscopic surgery: This is usually an outpatient procedure under general anesthesia. During surgery a lighted tube, called a cystoscope, is inserted into the urethral opening to see inside the bladder no incisions are made. A substance, called Deflux, is injected into the area where the ureter enters the bladder. Deflux helps prevent urine from flowing back into the ureter.

• #67 Vesicoureteral Reflux (VUR) | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/vesicoureteral-reflux-vur

  Ureteral reimplant: Under general anesthesia and through a lower abdominal incision, the ureter is reimplanted where it joins the bladder. Ureteral reimplantation corrects the anatomical abnormality that allows urine to flow back into the ureter. At CHOP this procedure can be done through a minimally invasive surgery (MIS) using a laparoscopic or robotic approach. This involves only a few small incisions instead of a larger lower abdominal incision. The benefits of MIS include a faster recovery, smaller incisions and a less noticeable scar. Most children go home the day after surgery.

• #68 Deflux Implant: Treatment for VUR, Procedure & Results

  https://my.clevelandclinic.org/health/treatments/16320-deflux-treatment-for-vesicoureteral-reflux

  Deflux is a gel that urologists can inject into your bladder to treat vesicoureteral reflux (VUR) pee flowing backwards into your ureters. Healthcare providers most often use it to treat VUR in kids. Deflux creates a bulge in your bladder that works as a valve to allow pee to enter your bladder but not back up into your ureters. […] Healthcare providers most commonly use Deflux to treat vesicoureteral reflux (VUR) in kids, but they can also use it to treat adults. […] VUR causes pee to back up into your ureters, and sometimes all the way to your kidneys. This can cause frequent urinary tract infections (UTIs), kidney scarring and other complications. […] Deflux can prevent urine backflow while you wait to see if the issue resolves on its own. […] Your provider may perform a follow-up voiding cystourethrogram (VCUG) to make sure the procedure was successful.

• #69 Vesicoureteral Reflux Treatment & Management: Approach Considerations, Active Surveillance, Medical Care

  https://emedicine.medscape.com/article/439403-treatment

  Clinical management of vesicoureteral reflux (VUR) is complex and should be individualized. The main health concern in patients with VUR is the occurrence of febrile urinary tract infection (UTI) or pyelonephritis, which may lead to renal scarring, hypertension, and renal insufficiency. On the other hand, VUR has a high rate of spontaneous resolution, especially in young patients and with low-grade VUR. The goals of treatment are to minimize over-treatment in patients with low risk of UTI and to prevent renal scarring. […] The philosophy of medical management is based on the knowledge that low-grade reflux resolves spontaneously and sterile reflux does not damage the kidney. Medical management involves the following: administering long-term suppressive antibiotics, correcting the underlying voiding dysfunction (if present), conducting follow-up radiographic studies (eg, voiding cystourethrography [VCUG], nuclear cystography, dimercaptosuccinic acid [DMSA] scan) at regular intervals.

• #70 Vesicoureteral reflux – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/vesicoureteral-reflux/diagnosis-treatment/drc-20378824

  Our caring team of Mayo Clinic experts can help you with your vesicoureteral reflux-related health concerns […] Treatment of vesicoureteral reflux at Mayo Clinic is unique in its individualized approach to medical care. Not all reflux is the same. Mayo Clinic’s pediatric urologists emphasize a thorough medical history and exam to fit each child and family. […] When surgery is needed, your Mayo Clinic care team implements a surgical plan designed to give the best results with the least invasive method. Mayo Clinic doctors are innovators of the hidden incision endoscopic surgery (HIdES) procedure. The incisions used for this surgery aren’t visible when the child wears a bathing suit.

• #71 Vesicoureteral Reflux (VUR): Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/5995-vesicoureteral-reflux

  Primary VUR may improve with age (typically by age 5). Sometimes, a wait-and-see approach works. Other times, surgery or medications are necessary. […] Healthcare providers treat secondary vesicoureteral reflux (VUR) by removing the blockage or improving how the bladder empties. Treatment may include: Surgery to remove a blockage or correct an irregularly shaped bladder or ureter. […] There isn’t a known way to prevent vesicoureteral reflux (VUR) not with food, lifestyle changes or medication. But there are steps you can take to improve your child’s overall urinary tract health. […] If your child receives a VUR diagnosis, work closely with their healthcare team on a treatment plan that works for your family. Managing a condition like VUR can have an effect on you and other caregivers. Be sure to discuss your concerns with your child’s healthcare team. The good news is that VUR is highly treatable and most children don’t have long-term effects from it.

• #72 Vesicoureteral Reflux (VUR) | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/vesicoureteral-reflux-vur

  Surgical intervention: Children who have grade 4 and 5 reflux or who have had repeated UTIs with concerns of kidney scarring, may require surgical intervention to fix the reflux. […] Many factors should be considered when deciding about what treatment is best for your child: the severity of the reflux, whether the reflux is in one or both ureters, your child’s age and gender and the presence of kidney damage. We will thoroughly discuss all options with you and your child. […] Endoscopic surgery: This is usually an outpatient procedure under general anesthesia. During surgery a lighted tube, called a cystoscope, is inserted into the urethral opening to see inside the bladder no incisions are made. A substance, called Deflux, is injected into the area where the ureter enters the bladder. Deflux helps prevent urine from flowing back into the ureter.

• #73 CE Activity | Vesicoureteral Reflux | Pharmacist

  https://www.statpearls.com/pharmacist/ce/activity/77957

  Vesicoureteral reflux (VUR) is characterized by the abnormal backward flow of urine from the urinary bladder into the upper urinary tract during voiding. This condition of retrograde urine flow is often caused by a short intramural ureter and is associated with recurrent urinary tract infections, renal cortical scarring, and renal failure in severe cases, including end-stage kidney disease. […] Patient education is crucial and includes treatment options while considering parental concerns and preferences, as VUR is typically diagnosed in children. This activity reviews the anatomy, pathophysiology, clinical presentation, diagnostic methods, and treatment options for VUR while emphasizing the importance of patient education in ensuring the long-term health of children with this condition.

• #74 The Diagnosis and Treatment of Vesicoureteral Reflux: An Update

  https://openurologyandnephrologyjournal.com/VOLUME/8/PAGE/96/

  Vesicoureteral reflux [VUR] remains a common problem seen by pediatric providers. […] The goals of managing VUR include preventing future febrile urinary tract infections [FUTI], renal scarring, reflux nephropathy and hypertension. […] The elimination of bladder and bowel dysfunction [BBD] is an important management strategy to prevent further FUTIs, regardless of treatment choice. […] The latest AUA VUR guidelines recognize this concomitant relationship between VUR, UTIs, and BBD. […] Due to this comorbidity, the AUA recommends screening for symptoms indicative of BBD upon initial evaluation. […] The guidelines recommend treatment of BBD prior to any surgical treatment of VUR. […] A critical driving force in the management of VUR is the presence of UTI and in particular FUTI. […] The association of UTIs with BBD is due to several characteristics of the lower urinary tract with BBD that provides an ideal environment for the propagation of uropathic bacteria.

• #75 The Diagnosis and Treatment of Vesicoureteral Reflux: An Update

  https://openurologyandnephrologyjournal.com/VOLUME/8/PAGE/96/

  Management of BBD initially consists of behavioral modification [termed standard urotherapy] that entails education regarding the anatomy and function of the bladder, bowel and pelvic floor musculature. […] Continuous antibiotic prophylaxis [CAP] is recommended for those with concomitant BBD and VUR due to an increased risk of UTI. […] Open ureteral reimplantation can be quite successful in the treatment of VUR in children, regardless of the presence of BBD. […] The evaluation for BBD in toilet-trained patients with VUR and UTIs should routinely be performed, as successful BBD management promotes downgrading or elimination of VUR.

• #76 The Diagnosis and Treatment of Vesicoureteral Reflux: An Update

  https://openurologyandnephrologyjournal.com/VOLUME/8/PAGE/96/

  Vesicoureteral reflux [VUR] remains a common problem seen by pediatric providers. […] The goals of managing VUR include preventing future febrile urinary tract infections [FUTI], renal scarring, reflux nephropathy and hypertension. […] The elimination of bladder and bowel dysfunction [BBD] is an important management strategy to prevent further FUTIs, regardless of treatment choice. […] The latest AUA VUR guidelines recognize this concomitant relationship between VUR, UTIs, and BBD. […] Due to this comorbidity, the AUA recommends screening for symptoms indicative of BBD upon initial evaluation. […] The guidelines recommend treatment of BBD prior to any surgical treatment of VUR. […] A critical driving force in the management of VUR is the presence of UTI and in particular FUTI. […] The association of UTIs with BBD is due to several characteristics of the lower urinary tract with BBD that provides an ideal environment for the propagation of uropathic bacteria.

• #77 The Diagnosis and Treatment of Vesicoureteral Reflux: An Update

  https://openurologyandnephrologyjournal.com/VOLUME/8/PAGE/96/

  Management of BBD initially consists of behavioral modification [termed standard urotherapy] that entails education regarding the anatomy and function of the bladder, bowel and pelvic floor musculature. […] Continuous antibiotic prophylaxis [CAP] is recommended for those with concomitant BBD and VUR due to an increased risk of UTI. […] Open ureteral reimplantation can be quite successful in the treatment of VUR in children, regardless of the presence of BBD. […] The evaluation for BBD in toilet-trained patients with VUR and UTIs should routinely be performed, as successful BBD management promotes downgrading or elimination of VUR.

• #78 Vesicoureteral Reflux Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/vesicoureteral-reflux-guideline

  Vesicoureteral reflux (VUR) and urinary tract infections (UTI) may detrimentally affect the overall health and renal function in affected children. This clinical guideline covers assessment, initial management, surgical treatment, and follow-up management of pediatric patients with such disorders. […] The goals of management of the child with VUR are to 1) prevent recurring febrile UTIs; 2) prevent renal injury; and 3) minimize the morbidity of treatment and follow-up. […] Continuous antibiotic prophylaxis is recommended for the child less than one year of age with VUR with a history of a febrile urinary tract infection. This approach is based on the greater morbidity from recurrent urinary tract infections found in this population. […] Continuous antibiotic prophylaxis is recommended for the child with bladder/bowel dysfunction and VUR due to the increased risk of urinary tract infection while bladder/bowel dysfunction is present and being treated.

• #79 Vesicoureteral reflux (VUR) and reflux nephropathy | infoKID

  https://infokid.org.uk/conditions/vesicoureteral-reflux-vur-and-reflux-nephropathy/

  Some children have complications health problems caused by or worsened by VUR or reflux nephropathy. […] Babies and children with a UTI may become irritable, have a fever, have pain on weeing, feel sick or be sick. […] This is more likely in severe VUR, when urine goes back up in the kidneys. […] In severe cases, the bladder does not empty properly, and this may cause more UTIs and further kidney damage. […] Reflux nephropathy may cause high blood pressure (hypertension) especially when a child is older or reaches adulthood. […] VUR sometimes runs in families. If one of your children has it, your doctor may recommend that his or her brothers and sisters are also tested, especially if they have any complications such as frequent UTIs. […] VUR is caused by a problem with the way one or both ureters connect with the bladder.

• #80 Vesicoureteral reflux (VUR) and reflux nephropathy | infoKID

  https://infokid.org.uk/conditions/vesicoureteral-reflux-vur-and-reflux-nephropathy/

  Some babies with antenatal hydronephrosis or other problems in pregnancy are tested for VUR after birth. […] Your child may also need to go back to the clinic or hospital for follow-up tests. […] Because VUR and reflux nephropathy may increase the risk of urinary tract infections (UTIs), especially infections that keep coming back and that may affect the kidney, some babies and children need to take a small dose of antibiotic medicine each day for some time. […] Some children need further treatment to protect their kidneys. […] All children with VUR need to go back to the clinic or hospital for more tests and to see the doctor. […] Children with reflux nephropathy need long-term follow-up. […] As they grow, most children have no symptoms from VUR or reflux nephropathy, especially after 5 years of age. […] A very small number of children, especially those with more severe VUR and/or reflux nephropathy, develop long-term problems with their kidneys and will need specialist treatment.

• #81 Pediatric Vesicoureteral Reflux Treatment & Management: Approach Considerations, Medical Care, Endoscopic Injection Therapy

  https://emedicine.medscape.com/article/1016439-treatment

  The importance of conscientious follow-up care during medical management cannot be overemphasized. Lack of compliance with medications or surveillance imaging may result in progression of reflux nephropathy and renal failure in children who are susceptible. […] The importance of aggressive bladder and bowel management for dysfunctional elimination cannot be overemphasized. […] Anticholinergic medication, in conjunction with timed voiding, may improve symptoms of dysfunctional voiding and reduces the risk of infection. […] Many of these patients benefit from some form of bladder training to achieve balanced, low-pressure voiding with coordinated relaxation of the external sphincter and pelvic floor. […] Good communication between the urologist and the primary care physician is essential for the effective management of VUR. This is especially true for children being treated medically, in whom regular follow-up care and prompt evaluation and treatment of breakthrough UTI are critical in preventing renal damage. […] Children whose VUR is being managed medically are regularly seen on an annual basis. Routine evaluation includes urinalysis and urine culture, appropriate imaging, and blood pressure measurement.

• #82 Pediatric Vesicoureteral Reflux Treatment & Management: Approach Considerations, Medical Care, Endoscopic Injection Therapy

  https://emedicine.medscape.com/article/1016439-treatment

  The importance of conscientious follow-up care during medical management cannot be overemphasized. Lack of compliance with medications or surveillance imaging may result in progression of reflux nephropathy and renal failure in children who are susceptible. […] The importance of aggressive bladder and bowel management for dysfunctional elimination cannot be overemphasized. […] Anticholinergic medication, in conjunction with timed voiding, may improve symptoms of dysfunctional voiding and reduces the risk of infection. […] Many of these patients benefit from some form of bladder training to achieve balanced, low-pressure voiding with coordinated relaxation of the external sphincter and pelvic floor. […] Good communication between the urologist and the primary care physician is essential for the effective management of VUR. This is especially true for children being treated medically, in whom regular follow-up care and prompt evaluation and treatment of breakthrough UTI are critical in preventing renal damage. […] Children whose VUR is being managed medically are regularly seen on an annual basis. Routine evaluation includes urinalysis and urine culture, appropriate imaging, and blood pressure measurement.

• #83 Vesicoureteral Reflux

  https://www.erlanger.org/childrens-health/conditions/vesicoureteral-reflux

  Vesicoureteral reflux (VUR) is the backward flow of urine from the bladder up the ureters toward the kidneys. […] Most children with VUR who get a UTI recover without long term complications. […] However, if a child outgrows VUR, long term monitoring of kidney function and blood pressure is still necessary. […] Treatment depends on the age of the child and severity of the UVR. […] Children with UTI and fever should be evaluated for VUR after the infection has been treated. […] After the diagnosis of VUR, prophylactic antibiotics are often prescribed to prevent future infections and reduce the risk of kidney scarring. […] Mild to moderate VUR often resolves spontaneously as children grow. […] More severe VUR or VUR that persists may require surgery. Surgical correction of VUR substantially reduces the likelihood of more kidney infections. […] Annual follow-up is recommended through adolescence.

• #84 8 Vesicoureteral Reflux (VUR) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/vesicoureteral-reflux-vur-nursing-care-plans/

  Goals and expected outcomes may include: The client will experience decreased pain. The client/parents will experience decreased anxiety. The parents will obtain information about child’s illness and treatment. The client will not experience injury as evidenced by absence of blood or clots in the urine, bladder is not distended and the client is able to urine after catheter removal. The client’s surgical incision will remain clean and dry without redness, edema, odor, or drainage. […] VUR can increase the risk of urinary tract infections and potentially lead to kidney damage. Minimizing injury risk and promoting safety are crucial considerations in the care of patients with vesicoureteral reflux (VUR). VUR condition can increase the risk of urinary tract infections (UTIs), renal damage, and other complications. Ensuring patient safety and minimizing injury risk are paramount to prevent further harm and optimize the well-being of individuals with VUR.

• #85 8 Vesicoureteral Reflux (VUR) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/vesicoureteral-reflux-vur-nursing-care-plans/

  Goals and expected outcomes may include: The client will experience decreased pain. The client/parents will experience decreased anxiety. The parents will obtain information about child’s illness and treatment. The client will not experience injury as evidenced by absence of blood or clots in the urine, bladder is not distended and the client is able to urine after catheter removal. The client’s surgical incision will remain clean and dry without redness, edema, odor, or drainage. […] VUR can increase the risk of urinary tract infections and potentially lead to kidney damage. Minimizing injury risk and promoting safety are crucial considerations in the care of patients with vesicoureteral reflux (VUR). VUR condition can increase the risk of urinary tract infections (UTIs), renal damage, and other complications. Ensuring patient safety and minimizing injury risk are paramount to prevent further harm and optimize the well-being of individuals with VUR.

• #86 Vesicoureteral Reflux (VUR) | Diagnosis & Treatment

  https://www.cincinnatichildrens.org/health/v/vesicoureteral-reflux

  The goals of surgery are to: Correct the reflux, Prevent pyelonephritis (kidney infection), Preserve renal function. […] After reflux surgery, there may be limits on physical activity. This will be based on what your surgeon decides. Voiding every two to three hours as well as drinking adequate fluids helps healing. Your child may return to school the day after surgery. […] Healthy bladder habits are vital. These include drinking an adequate amount of water and avoiding bladder irritants in the diet. Good perineal hygiene, even more so in girls, along with voiding every three to four hours, helps to prevent urinary tract infections.

• #87 8 Vesicoureteral Reflux (VUR) Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/vesicoureteral-reflux-vur-nursing-care-plans/

  Goals and expected outcomes may include: The client will experience decreased pain. The client/parents will experience decreased anxiety. The parents will obtain information about child’s illness and treatment. The client will not experience injury as evidenced by absence of blood or clots in the urine, bladder is not distended and the client is able to urine after catheter removal. The client’s surgical incision will remain clean and dry without redness, edema, odor, or drainage. […] VUR can increase the risk of urinary tract infections and potentially lead to kidney damage. Minimizing injury risk and promoting safety are crucial considerations in the care of patients with vesicoureteral reflux (VUR). VUR condition can increase the risk of urinary tract infections (UTIs), renal damage, and other complications. Ensuring patient safety and minimizing injury risk are paramount to prevent further harm and optimize the well-being of individuals with VUR.

• #88 Vesicoureteral Reflux Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/vesicoureteral-reflux-guideline

  Vesicoureteral reflux (VUR) and urinary tract infections (UTI) may detrimentally affect the overall health and renal function in affected children. This clinical guideline covers assessment, initial management, surgical treatment, and follow-up management of pediatric patients with such disorders. […] The goals of management of the child with VUR are to 1) prevent recurring febrile UTIs; 2) prevent renal injury; and 3) minimize the morbidity of treatment and follow-up. […] Continuous antibiotic prophylaxis is recommended for the child less than one year of age with VUR with a history of a febrile urinary tract infection. This approach is based on the greater morbidity from recurrent urinary tract infections found in this population. […] Continuous antibiotic prophylaxis is recommended for the child with bladder/bowel dysfunction and VUR due to the increased risk of urinary tract infection while bladder/bowel dysfunction is present and being treated.

• #89 Vesicoureteral Reflux (VUR) in Infants & Children | National Kidney Foundation

  https://www.kidney.org/kidney-topics/vesicoureteral-reflux-vur-infants-children

  Some children are given a low dose of an antibiotic every day to decrease the risk of developing a UTI while waiting to see if they outgrow the VUR. […] If VUR is severe and does not get better, or if there are repeated kidney UTIs with fever, a child may benefit from surgery that fixes the leaky valve between the bladder and the ureter. […] Continue to help your child with healthy bladder and bowel habits. All potty-trained children with VUR need to work on this to help prevent UTIs. […] It is also important that children completely empty their bladder every 2-3 hours when they are awake. Children should avoid holding their urine for long periods. This helps keep the bladder clean and prevents UTIs. […] Many children grow out of VUR over time, often by age 5. Finding VUR early and monitoring it closely with your child’s doctors–and getting treatment if needed–will help avoid any lasting problems.

• #90 Vesicoureteral Reflux (VUR) in Infants & Children | National Kidney Foundation

  https://www.kidney.org/kidney-topics/vesicoureteral-reflux-vur-infants-children

  Some children are given a low dose of an antibiotic every day to decrease the risk of developing a UTI while waiting to see if they outgrow the VUR. […] If VUR is severe and does not get better, or if there are repeated kidney UTIs with fever, a child may benefit from surgery that fixes the leaky valve between the bladder and the ureter. […] Continue to help your child with healthy bladder and bowel habits. All potty-trained children with VUR need to work on this to help prevent UTIs. […] It is also important that children completely empty their bladder every 2-3 hours when they are awake. Children should avoid holding their urine for long periods. This helps keep the bladder clean and prevents UTIs. […] Many children grow out of VUR over time, often by age 5. Finding VUR early and monitoring it closely with your child’s doctors–and getting treatment if needed–will help avoid any lasting problems.

• #91 Vesicoureteral Reflux | Department of Urology

  https://www.med.unc.edu/urology/pediatrics/pediatric-conditions/vesicoureteral-reflux/

  Reflux is a silent problem and alone does not cause pain or discomfort with urination. […] It is important to prevent urinary tract infection in children with known reflux to protect kidneys from potentially harmful bacteria. The child must take a daily preventative dose of antibiotic medication (often Septra or Macrodantin) to keep the urine sterile. […] The reflux is corrected by a procedure called Vesicoureteral Reimplantation and is performed either laparoscopically or through a small incision in the lower abdomen at the bikini line. […] Following surgery, the child will have a urethral catheter in place and may have one or two small tubes called ureteral stents from the incision. These tubes will be connected to a drainage bag and are usually removed before the child is discharged from the hospital. […] In experienced hands, the success rate for the correction of reflux is 98%.

• #92 Vesicoureteral Reflux

  https://www.erlanger.org/childrens-health/conditions/vesicoureteral-reflux

  Vesicoureteral reflux (VUR) is the backward flow of urine from the bladder up the ureters toward the kidneys. […] Most children with VUR who get a UTI recover without long term complications. […] However, if a child outgrows VUR, long term monitoring of kidney function and blood pressure is still necessary. […] Treatment depends on the age of the child and severity of the UVR. […] Children with UTI and fever should be evaluated for VUR after the infection has been treated. […] After the diagnosis of VUR, prophylactic antibiotics are often prescribed to prevent future infections and reduce the risk of kidney scarring. […] Mild to moderate VUR often resolves spontaneously as children grow. […] More severe VUR or VUR that persists may require surgery. Surgical correction of VUR substantially reduces the likelihood of more kidney infections. […] Annual follow-up is recommended through adolescence.

• #93 Vesicoureteral reflux – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/vesicoureteral-reflux/symptoms-causes/syc-20378819

  Call a healthcare professional right away if your child has any UTI symptoms, such as: A strong, persistent urge to urinate. A burning sensation when urinating. Pain in the stomach area, groin or side. Upset stomach or vomiting. […] Kidney damage is the main health concern, also called complication, that can happen with vesicoureteral reflux. The worse the reflux, the more serious the complications are likely to be. […] Complications may include: Kidney scarring. Without treatment, UTIs can lead to lasting damage to kidney tissue known as scarring. Extensive scarring may lead to high blood pressure and kidney failure.

• #94 Vesicoureteral Reflux Treatment & Management: Approach Considerations, Active Surveillance, Medical Care

  https://emedicine.medscape.com/article/439403-treatment

  Continuous antibacterial prophylaxis decreases the incidence of pyelonephritis and subsequent renal scarring for low-to-moderate grades of reflux. Therefore, nonsurgical management is appropriate for mild-to-moderate VUR (ie, grades I-IV) in the absence of breakthrough infections or anatomic abnormalities, as discussed above. […] Surgery (ureteral reimplantation or ureteroneocystostomy) is the definitive method of correcting primary reflux, especially in the setting of anatomic abnormalities. […] Complications include the following: persistent, transient, contralateral reflux, postoperative ureteral obstruction, hematuria, urosepsis, anuria. […] Yearly ultrasonography helps to monitor renal growth, to detect hydronephrosis, and to evaluate bladder anatomy and voiding dynamics (filling and emptying). However, this is not mandatory, especially if the patient has not had evidence of febrile UTI and has had normal findings on initial ultrasonography.

• #95 Deflux Implant: Treatment for VUR, Procedure & Results

  https://my.clevelandclinic.org/health/treatments/16320-deflux-treatment-for-vesicoureteral-reflux

  A Deflux implant can treat VUR for up to 25 years. […] Risks of placing a Deflux implant include: Bruising and swelling. Bladder damage. Blockage of your ureter. […] Sometimes, VUR and UTIs continue despite treatment. You may need additional injections if your symptoms continue after one Deflux treatment. […] Vesicoureteral reflux can cause frequent infections from pee backing up into your ureters. If your child has VUR, you may wonder what the best treatment options are. A urologist may suggest a Deflux injection. Deflux injections are safe and minimally invasive, but their effectiveness can vary. They might not work as well if you or your child has severe VUR.

• #96 New clinical evidence shifts approach to vesicoureteral reflux (VUR) care – CHOC Pediatrica

  https://care.choc.org/personalized-medicine-surgical-innovations-advance-pediatric-brain-tumor-care-2/

  In general, surgical intervention is offered to those with high-grade VUR who have recurrent kidney infections and potential for further kidney damage. […] Our goal is to protect the kidneys and bladder. […] By constantly evaluating our diagnostic and treatment best practices, we force ourselves to consider whether a change in care would mean better outcomes for our patients. […] When supported by clinical evidence, we make the appropriate modification and VUR patients reap the benefit.

• #97 New clinical evidence shifts approach to vesicoureteral reflux (VUR) care – CHOC Pediatrica

  https://care.choc.org/personalized-medicine-surgical-innovations-advance-pediatric-brain-tumor-care-2/

  New clinical evidence shifts approach to vesicoureteral reflux (VUR) care […] The practice of treating vesicoureteral reflux (VUR) with follow-up tests is questioned by CHOC urologists because it’s often unnecessary. […] One of the most common conditions managed by pediatric urologists is vesicoureteral reflux (VUR), which occurs when urine in the bladder flows back into the ureters and/or kidneys. […] Recently, this approach has been questioned, and CHOC urologists have determined that repeated follow-up testing for some patient groups is often unnecessary. […] Our goal is to stratify patients by risk factors and severity to diagnose and treat at the appropriate level. […] These classifications now drive patient care at CHOC. […] At CHOC, repeat testing is reserved for those with persistent symptoms such as urinary tract infections with fever or those in the high-risk category.

• #98 New clinical evidence shifts approach to vesicoureteral reflux (VUR) care – CHOC Pediatrica

  https://care.choc.org/personalized-medicine-surgical-innovations-advance-pediatric-brain-tumor-care-2/

  New clinical evidence shifts approach to vesicoureteral reflux (VUR) care […] The practice of treating vesicoureteral reflux (VUR) with follow-up tests is questioned by CHOC urologists because it’s often unnecessary. […] One of the most common conditions managed by pediatric urologists is vesicoureteral reflux (VUR), which occurs when urine in the bladder flows back into the ureters and/or kidneys. […] Recently, this approach has been questioned, and CHOC urologists have determined that repeated follow-up testing for some patient groups is often unnecessary. […] Our goal is to stratify patients by risk factors and severity to diagnose and treat at the appropriate level. […] These classifications now drive patient care at CHOC. […] At CHOC, repeat testing is reserved for those with persistent symptoms such as urinary tract infections with fever or those in the high-risk category.

• #99 New clinical evidence shifts approach to vesicoureteral reflux (VUR) care – CHOC Pediatrica

  https://care.choc.org/personalized-medicine-surgical-innovations-advance-pediatric-brain-tumor-care-2/

  New clinical evidence shifts approach to vesicoureteral reflux (VUR) care […] The practice of treating vesicoureteral reflux (VUR) with follow-up tests is questioned by CHOC urologists because it’s often unnecessary. […] One of the most common conditions managed by pediatric urologists is vesicoureteral reflux (VUR), which occurs when urine in the bladder flows back into the ureters and/or kidneys. […] Recently, this approach has been questioned, and CHOC urologists have determined that repeated follow-up testing for some patient groups is often unnecessary. […] Our goal is to stratify patients by risk factors and severity to diagnose and treat at the appropriate level. […] These classifications now drive patient care at CHOC. […] At CHOC, repeat testing is reserved for those with persistent symptoms such as urinary tract infections with fever or those in the high-risk category.

• #100 Vesicoureteral reflux – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/vesicoureteral-reflux/diagnosis-treatment/drc-20378824

  Our caring team of Mayo Clinic experts can help you with your vesicoureteral reflux-related health concerns […] Treatment of vesicoureteral reflux at Mayo Clinic is unique in its individualized approach to medical care. Not all reflux is the same. Mayo Clinic’s pediatric urologists emphasize a thorough medical history and exam to fit each child and family. […] When surgery is needed, your Mayo Clinic care team implements a surgical plan designed to give the best results with the least invasive method. Mayo Clinic doctors are innovators of the hidden incision endoscopic surgery (HIdES) procedure. The incisions used for this surgery aren’t visible when the child wears a bathing suit.

• #101 New clinical evidence shifts approach to vesicoureteral reflux (VUR) care – CHOC Pediatrica

  https://care.choc.org/personalized-medicine-surgical-innovations-advance-pediatric-brain-tumor-care-2/

  While diagnosing patients with high-risk disease is important, it’s equally as important to minimize over-diagnosis of patients with low-risk disease who will likely remain asymptomatic with no long-term sequelae. […] We want to focus on finding the patients at the highest risk for long-term sequelae who truly require treatment to prevent further upper tract damage. […] Stratified treatment for VUR begins with the least-invasive option: expectant management with behavioral modifications to ensure healthy bowel and bladder habits. […] In children at intermediate or high risk, a low-dose daily antibiotic may be prescribed along with an intent focus on bowel and bladder management in the toilet-trained child. […] Surgical intervention, such as an open ureteral reimplant or endoscopic treatment with injection of Deflux® (a bulking agent to prevent urinary reflux) is also available.

• #102 New clinical evidence shifts approach to vesicoureteral reflux (VUR) care – CHOC Pediatrica

  https://care.choc.org/personalized-medicine-surgical-innovations-advance-pediatric-brain-tumor-care-2/

  While diagnosing patients with high-risk disease is important, it’s equally as important to minimize over-diagnosis of patients with low-risk disease who will likely remain asymptomatic with no long-term sequelae. […] We want to focus on finding the patients at the highest risk for long-term sequelae who truly require treatment to prevent further upper tract damage. […] Stratified treatment for VUR begins with the least-invasive option: expectant management with behavioral modifications to ensure healthy bowel and bladder habits. […] In children at intermediate or high risk, a low-dose daily antibiotic may be prescribed along with an intent focus on bowel and bladder management in the toilet-trained child. […] Surgical intervention, such as an open ureteral reimplant or endoscopic treatment with injection of Deflux® (a bulking agent to prevent urinary reflux) is also available.

• #103 New clinical evidence shifts approach to vesicoureteral reflux (VUR) care – CHOC Pediatrica

  https://care.choc.org/personalized-medicine-surgical-innovations-advance-pediatric-brain-tumor-care-2/

  In general, surgical intervention is offered to those with high-grade VUR who have recurrent kidney infections and potential for further kidney damage. […] Our goal is to protect the kidneys and bladder. […] By constantly evaluating our diagnostic and treatment best practices, we force ourselves to consider whether a change in care would mean better outcomes for our patients. […] When supported by clinical evidence, we make the appropriate modification and VUR patients reap the benefit.

• #104 New clinical evidence shifts approach to vesicoureteral reflux (VUR) care – CHOC Pediatrica

  https://care.choc.org/personalized-medicine-surgical-innovations-advance-pediatric-brain-tumor-care-2/

  While diagnosing patients with high-risk disease is important, it’s equally as important to minimize over-diagnosis of patients with low-risk disease who will likely remain asymptomatic with no long-term sequelae. […] We want to focus on finding the patients at the highest risk for long-term sequelae who truly require treatment to prevent further upper tract damage. […] Stratified treatment for VUR begins with the least-invasive option: expectant management with behavioral modifications to ensure healthy bowel and bladder habits. […] In children at intermediate or high risk, a low-dose daily antibiotic may be prescribed along with an intent focus on bowel and bladder management in the toilet-trained child. […] Surgical intervention, such as an open ureteral reimplant or endoscopic treatment with injection of Deflux® (a bulking agent to prevent urinary reflux) is also available.

• #105 New clinical evidence shifts approach to vesicoureteral reflux (VUR) care – CHOC Pediatrica

  https://care.choc.org/personalized-medicine-surgical-innovations-advance-pediatric-brain-tumor-care-2/

  While diagnosing patients with high-risk disease is important, it’s equally as important to minimize over-diagnosis of patients with low-risk disease who will likely remain asymptomatic with no long-term sequelae. […] We want to focus on finding the patients at the highest risk for long-term sequelae who truly require treatment to prevent further upper tract damage. […] Stratified treatment for VUR begins with the least-invasive option: expectant management with behavioral modifications to ensure healthy bowel and bladder habits. […] In children at intermediate or high risk, a low-dose daily antibiotic may be prescribed along with an intent focus on bowel and bladder management in the toilet-trained child. […] Surgical intervention, such as an open ureteral reimplant or endoscopic treatment with injection of Deflux® (a bulking agent to prevent urinary reflux) is also available.

• #106 New clinical evidence shifts approach to vesicoureteral reflux (VUR) care – CHOC Pediatrica

  https://care.choc.org/personalized-medicine-surgical-innovations-advance-pediatric-brain-tumor-care-2/

  In general, surgical intervention is offered to those with high-grade VUR who have recurrent kidney infections and potential for further kidney damage. […] Our goal is to protect the kidneys and bladder. […] By constantly evaluating our diagnostic and treatment best practices, we force ourselves to consider whether a change in care would mean better outcomes for our patients. […] When supported by clinical evidence, we make the appropriate modification and VUR patients reap the benefit.

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