A short intramural ureter results into failure of the flap-valve mechanism.
Secondary VUR is associated with abnormal high pressure build up in the bladder. It follows that a flap-valve mechanism failure at the intramural ureter is due to this high pressure. Posterior urethral valves and neurogenic bladder are normally associated with clinical conditions that lead to secondary reflux. The retrograde flow of urine is checked as the intramural ureter is passively compressed while the bladder fills. The disorder has been subjected to great scrutiny especially in relation to the general importance of the disorder as a clinical entity in renal development and function.
Statistics reveal that 1% of normal children are usually affected by this disorder. Approximately 30-50% of children with urinary tract infections are also affected (Aappublications.org., 2011). It should also be noted that 10% of the children with prenatally diagnosed hydronephrosis have been reported to have the disorder. However, its treatment has since remained to be clouded with a lot of controversies in pediatric urology in addition to the fact that it represents one of the most significant risk factors for acute pyelonephritis in children. Common knowledge has it that pediatric nephrologists, pediatric urologists and pediatrics in general, have frequently encountered VUR. This has led to the conclusion that VUR is a prevalent disorder.
According to Moyer and Elliot (2004) the above mentioned specialists’ groups will only work to help patients with VUR on condition that a synergistic relationship exists between them. It will then be realistic to guarantee special care for the respective patients. Surgical correction of VUR is highly dependent on the availability of renal scars; in relation to current indications. Anti-reflux surgery is only indicated in high-grade bilateral VUR in the absence of scars. The last 50 years have witnessed