Medically reviewed by: Dr. Anthony Kallas Chemaly
Last reviewed: April 5, 2026
Sources used on this page: trusted clinical references and pediatric-hospital resources listed below.
What is Vesicoureteral Reflux (VUR) Treatment in Lebanon?
Vesicoureteral reflux (VUR) is a condition where urine flows backward from the bladder into one or both ureters and potentially up to the kidneys. Normally, urine flows in one direction — from the kidneys through the ureters to the bladder. When the valve mechanism at the junction of the ureter and bladder is defective, urine can reflux upward, carrying bacteria and causing recurrent urinary tract infections (UTIs) and, if untreated, kidney damage (reflux nephropathy). VUR is graded from I (mild) to V (severe) and affects approximately 1–2% of children.
Signs and Symptoms
The most common presentation is a urinary tract infection (UTI) — especially febrile UTIs in infants and young children. Signs to watch for include: fever without an obvious source (especially in infants), foul-smelling or cloudy urine, pain or burning during urination, frequent urination or urgency, abdominal or flank pain, and poor weight gain in infants. In some cases, VUR is detected prenatally when hydronephrosis (kidney swelling) is found on ultrasound.
When to See a Pediatric Urologist
Consult a pediatric urologist if your child has had a febrile UTI (especially under age 2), recurrent UTIs, prenatal hydronephrosis, or if imaging has shown evidence of kidney scarring. Early diagnosis and management are critical to preventing permanent kidney damage.
How Is It Diagnosed?
Diagnosis involves a voiding cystourethrogram (VCUG) — an imaging study where contrast dye is placed in the bladder through a small catheter, and X-rays are taken as the child urinates. This shows whether urine refluxes and to what grade. A renal ultrasound assesses kidney size and shape, and a DMSA scan may be used to check for kidney scarring. Dr. Kallas Chemaly published a landmark multicenter study comparing open versus laparoscopic Lich-Gregoir reimplantation for VUR, published in Frontiers in Pediatrics.
Treatment Options
Treatment depends on the grade and clinical presentation. Low-grade reflux (I–II) often resolves spontaneously and can be managed with antibiotic prophylaxis and monitoring. Higher-grade reflux (III–V), recurrent breakthrough infections, or evidence of kidney scarring may require surgical correction. Surgical options include endoscopic injection (Deflux), open ureteral reimplantation, and laparoscopic extravesical reimplantation (Lich-Gregoir technique). Dr. Kallas Chemaly has specific expertise in laparoscopic reimplantation, having co-authored a major multicenter study on the technique comparing open versus laparoscopic outcomes.
Dr. Kallas Chemaly's Approach
Dr. Kallas Chemaly evaluates each child with VUR comprehensively — considering grade, age, infection history, kidney function, and family preferences. He does not rush to surgery when monitoring is appropriate, but he does not delay when the kidneys are at risk. His expertise in laparoscopic reimplantation offers families a minimally invasive option with faster recovery and excellent success rates. He was featured on MTV Lebanon discussing VUR management in children.
References
- Stanford Medicine Children's Health: Vesicoureteral Reflux (VUR) in Children
- Children's National Hospital: Pediatric Vesicoureteral Reflux
- Johns Hopkins Medicine: Vesicoureteral Reflux (VUR)
Serving families across Beirut and Mount Lebanon
Dr. Kallas Chemaly treats Vesicoureteral Reflux (VUR) Treatment in Lebanon in children from Achrafieh, Gemmayzeh, Saifi, Sodeco, Verdun, Hamra, Clemenceau, Ras Beirut, Rabieh, Mtayleb, Brummana, Beit Mery, Bikfaya, Mansourieh, Kornet Chehwan, Antelias, Dbayeh, Jounieh, Kaslik, Hazmieh, Yarze, and across Keserwan, Metn, and Baabda.