Symptoms of vesicoureteral reflux in children

Symptoms of vesicoureteral reflux may be subtle, and this condition is detected during examination of children with complications of vesicoureteral reflux (eg, pyelonephritis).

However, there are general symptoms characteristic of children with vesicoureteral reflux: delayed physical development, low birth weight, a large number of stigmas of dysembryogenesis, neurogenic dysfunction of the bladder, repeated "causeless" increases in temperature, abdominal pain, especially associated with urination. However, these symptoms are characteristic of many diseases.

The most pathognomonic for vesicoureteral reflux is a violation of the act of urination, especially of a recurrent nature with changes in urine tests. In this case, symptoms characteristic of an uninhibited bladder are noted: frequent urination in small portions with imperative urges, incontinence, urinary incontinence, and closer to the age of three, rare, two-stage, difficult urination is quite often observed. High blood pressure is more often found with gross cicatricial changes in the kidneys, which is unfavorable in terms of prognosis.

The clinical picture of reflux also depends on the nature of its complications and concomitant pathology: pyelonephritis, cystitis, neurogenic dysfunction of the bladder. However, occurring against the background of vesicoureteral reflux, these diseases acquire some peculiarity. Thus, pyelonephritis, occurring against the background of this pathology, is much more often accompanied by severe pain syndrome, and the pain can be both non-localized and localized along the ureters, in the projection area of the bladder, in the lumbar region, in the periumbilical region. In the clinical picture, it seems that urination disorders seem to be ahead of the clinical picture of kidney inflammation. Such disorders as daytime incontinence and urinary incontinence, enuresis, and other dysuric phenomena can be associated with the manifestation of various forms of neurogenic bladder, often combined with vesicoureteral reflux. Thus, in hypermotor forms of neurogenic bladder, imperative urges to urinate, incontinence, urinary incontinence, frequent urination in small portions are observed. Less common are children with hypomotor dysfunctions with a weakened urge to urinate, difficult urination, large portions of urine, which is more typical for "adult patients". Disorders of the act of urination are often combined with constipation, which is manifested by a weakening of the urge to defecate or its absence, difficult defecation or its irregularity, imperative urges to defecate with an overflowing colon with possible encopresis.