Hi,

Thanks for the query

The progression of the Vesicoureteric Reflux from Grade 3 to 4 is indeed a matter of concern. Vesicoureteric reflux is one of the commonest urinary tract problems seen in the children and is more common in females.

This is a condition wherein there is backflow of urine from the bladder into the ureter and then into the kidney. During the backflow there are chances of the microorganisms being carried into the kidney causing urinary tract infection and scarring of the kidney.

Reflux is graded on a scale from 1 to 5. Grade 1 is the mildest of reflux while Grade 5 is the most severe. Most low-grade reflux will resolve without surgery whereas the high-grade reflux may require surgery. The main goal of reflux management is to protect the kidneys from infection and scarring. Any patient under observation who develops a recurrent urinary tract infection or new renal scarring should undergo surgical correction of reflux.

Following are the factors to recommend surgery:
1. Recurrent infections despite the use of antibiotics
2. Worsening or persistence of reflux
3. High-grade reflux
4. Delayed kidney growth
5. The presence of renal scarring

The standard operation for vesicoureteral reflux is ureteral reimplantation, which is successful in 95 percent of cases. The surgical options include open surgery, endoscopic and laparoscopic approach.

It is wise to go by the advice of the urologist as the kidneys are one of the important organs of our body. The more the surgery is delayed the assault on kidneys continues and once they are damaged they are damaged forever and remember age is no barrier for the corrective surgery.

Hope I have answered your query, if you have any more doubts you are welcome.

Regards,
Dr. Naveen Kumar

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