Dear Alice,

I’m having a burning sensation when I urinate and it still burns after I urinate. Also, I can’t urinate all the way and am continually having to go to the bathroom. I was diagnosed with kidney reflux when I was a child — could this be that?

Dear Reader,

Without visiting your health care provider, it may be difficult to determine why you are experiencing a burning sensation when you urinate. But, it’s possible that your childhood condition could be associated with your current difficulty with urination. Having had kidney reflux in the past could predispose you to having recurring infections of the bladder, ureter, and kidneys. That being said, seeking medical attention may help you feel better in short order; even if the health care provider can’t answer all your questions about whether former kidney reflux is necessarily related to your burning and difficulty urinating now.

Kidney reflux, or vesicoureteral reflux (VUR), is a not an uncommon condition in newborns or young children who show some signs of urinary troubles and typically involves the ureter, a tube that brings urine down into the bladder after it’s been filtered in the kidney. There are two forms of VUR: primary and secondary. Primary VUR occurs when the ureter is just a little short and doesn’t quite reach deep enough into the bladder; this often resolves on its own during normal growth and development in early childhood. In secondary VUR, the tube connecting the kidney and the bladder doesn’t close all the way; so when the bladder contracts (and the body tries to get rid of urine), urine travels backward toward the kidney. Sometimes this is because the bladder itself is obstructed and urine can’t leave the body as it’s intended.

More to your question, Reader, health care providers previously thought that having VUR meant that you would be more likely to get urinary tract infections (UTIs) because, if urine doesn’t flow easily from the kidney to the bladder at a regular rate, small microbes or bacteria could get into these small spaces and multiply, causing a painful infection. Some literature claims that resulting urinary tract infections may lead to renal damage if left untreated. Whether VUR means that you will experience chronic kidney disease later in life hasn’t been proven, and there’s disagreement about this even amongst well-educated health care providers.

Treatment for VUR has been primarily aimed at preventing renal scarring (permanent damage to the kidney tissue) and UTIs through a low daily dose of antibiotics until the VUR is resolved. More rarely, surgery has been used to help better connect the ureter with the bladder. For children who have undergone surgery to correct this condition, researchers have observed higher rates of UTIs after surgery as well as later in life. If your health care provider knows that you’ve had VUR in the past, s/he may decide to monitor your kidneys to make sure everything is flowing in the right direction. Simply visiting a health care provider to check on whether you’re experiencing a UTI currently might help you feel more comfortable in the short-term.

Alice!

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