[Symptomatic vesicoureteral reflux in the adult age. A patient's testimony].
OBJECTIVE
There is a general opinion about that vesicoureteral reflux (VUR) rarely produces symptoms during adulthood. But it is possible to find active VUR over 20 years of age. A case report of a woman 28 years old with symptomatic VUR is presented with description of the "Reflux Pain" by herself. The objective of this article is to study the clinical aspects of symptomatic VUR in an adult woman with impairment in her quality of life.


RESULTS
She was a 33 years old female patient, with chronic and febrile breakthrough urinary tract infections (UTI) since she was 28 years of age. Then an unknown bilateral VUR was diagnosed. It was grade III in an incompletely duplicated right side and grade II in the left one. She recived antibiotic prophylaxis (AP) for 4 years, in spite of it she had a temperature over 37 degrees, with frequent peaks over 38 degrees, and she lost 8 KG of weight. She also had lumbar pain and "Reflux Pain", which was described by the patient as: "acute, intense, excruciating, ascending, located in the ureters and kidneys, beginning some minutes before urinating and finishing some minutes later. During these 4 years many others pathologies were ruled out looking for other etiology of the temperature of "unknown origin". Finally she was sent to urology for treatment of VUR. Bilateral Endoscopic Treatment (ET) with non animal stabilized Hyaluronic acid/ Dextranomer (DX/NASHA) gel was performed, with good result after the first injection. "Reflux Pain" disappeared few days after ET and after one month the temperature was under 37 degrees. She remains asymptomatic after 4 years of follow up.


CONCLUSIONS
VUR can produce symptoms during adulthood, with a very typical pain easy to identify, chronic pyelonephritis with temperature and progressive deterioration. ET can eliminate VUR, stop the symptoms and improve quality of life.
Miguélez Lago
Carlos
C
Urología Pediátrica, Clínica Santa Elena, Torremolinos, Málaga, España. miguelezlago@hotmail.com
Moreno Román
Jairo
J
D000328:Adult; D005260:Female; D006801:Humans; D011788:Quality of Life; D014718:Vesico-Ureteral Reflux