The Role of Foley Catheter in the Treatment of Low Grades Vesico-Ureteric Reflux (VUR)

Abstract

Vesicoureteral reflux can be defined as a congenital anomalies of the lower urinary tract characterize by a
defect in the vesico-ureteric valve (which is a functional valve result from the oblique intramural passage of
the lower 2.5 cm. of the ureters in wall of the bladder) resulting in retrograde passage of urine into one or
both ureters up to the kidneys during voiding. From March 2014 to June 2016, 60 (38 males and 22 females)
children with low-grade primary VUR (10 with G1, 16 had G2 and 34 had G3) who are seeking medical
advice in the urological department of Alhilla teaching and Alsadiq teaching hospitals and private clinics were
included in this study. All patients evaluated by thorough medical history, complete physical examination,
send for urinalysis, PCV, and ultrasonography, and confirm the diagnosis by voiding cystography. No Foley
catheter put for patients with G1 VUR, while Foley catheter put for eight patients with G2 VUR (50%) and
for 20 patients with G3 reflux (58.8%). Patients are fallowed for at least 1 year for any breakthrough upper
or lower urinary tract infection and for the grade of reflux by frequent urinalysis and ultrasonography for
any new renal scaring while voiding cystography repeat every 6 months. Conservative treatment is the first
option in the treatment of low grade VUR. The use of indwelling Foley catheter in the treatment of low grade
VUR remain controversy regarding its role in decreasing the back pressure on the renal parenchyma and its
increasing rate of UTI .however this study reveal that the incidence of UTI occur in 6.25% of cases treated
with continuous prophylactic antibiotic (CPA) alone and occur in 25% of cases treated with CPA with Foley
catheter placement.