Abstract
Vesicoureteral reflux (VUR) is the most common urologic pathology in the pediatric population. VUR is defined as primary when the intravesical portion of the ureters is short and produces an incompetent ureterovesical junction. Secondary VUR is caused by anatomical or functional obstruction to bladder emptying, which in turn increases the bladder internal pressure, therefore overcoming the ureterovesical junction and causing reflux.
Highlights
In this work we present the case of a 6-year-old male patient who presented to a rural clinic in Mexico, where after a thorough medical work up, we found severe bilateral hydronephrosis caused by vesicoureteral reflux
We provide an analysis of the pathology with the current guideline recommendations
Vesicoureteral reflux (VUR) is a urologic pathology characterized by retrograde passage of urine from the bladder to the upper urinary tract
Summary
In this work we present the case of a 6-year-old male patient who presented to a rural clinic in Mexico, where after a thorough medical work up, we found severe bilateral hydronephrosis caused by vesicoureteral reflux. The mother noticed them four days previously, and described them as mobile, and non-painful. She endorsed symptoms consistent with an upper respiratory tract infection, without fever. She mentioned that her child has had approximately four episodes of self-resolving epistaxis in the previous 2 to 3 months. Because of the urinalysis suggesting a urinary tract infection in a male patient and the low weight, a kidney, ureter and bladder ultrasound was ordered to look for any anatomical or structural abnormalities (Figure 1). Before the vesicoureteral reflux diagnosis was clear, the patient was treated for a presumed urinary tract infection with PO amoxicillin/clavulanate for 5 days. The patient was eventually referred to a pediatric urologist for further surgical management
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