(VUR—Child; Reflux Nephropathy—Child; Chronic Atrophic Pyelonephritis—Child; Vesico-Ureteric Reflux—Child; Ureteral Reflux—Child)
Pronounced: VEH-sih-co-ya-REET-uh-rul REE-flux
by Sonja Lyons and Rebecca J. Stahl, MA
Vesicoureteral reflux (VUR) is the backward flow of urine. The urine flows from the bladder back into the kidneys.
Urine normally flows out from the kidneys. It passes through tubes called ureters. It then flows into the bladder. Each ureter connects to the bladder in a way that prevents urine from flowing back up the ureter. This connection is similar to a one-way valve. When this does not work properly, or if the ureters do not extend far enough into the bladder, urine may flow back up to the kidney. If the urine contains bacteria, the kidney may become infected. The back-up can also put extra pressure on the kidney. This can cause kidney damage.
This is a potentially serious condition. It requires care from a doctor. Early treatment and prevention of infections can lead to better outcomes. If you suspect your child has this condition, call the doctor right away.
Common causes of VUR include:
Risk Factors TOP
The following factors increase your child’s chance of developing VUR:
The doctor will ask about your child’s symptoms and medical history. A physical exam will be done. Tests may include:
The doctor will grade your child’s condition. The grading scale ranges from 1 (mild) to 5 (severe).
The goal for treatment of VUR is to prevent any permanent kidney damage. Treatment options include:
If your child’s condition is graded 1-3, he may not need treatment right away. VUR may go away on its own as the ureters develop. The doctor will monitor your child’s condition. This may include:
Children are advised to stay well-hydrated by drinking plenty of fluids. They should also empty their bladders frequently.
In most cases, surgery is not needed. If your child does need surgery, the options include:
VUR cannot be prevented in most cases. You can help your child avoid complications by calling the doctor right away if you think she has a bladder or kidney infection.
American Urological Association
National Kidney Foundation
BC Health Guide
The Kidney Foundation of Canada: British Columbia Branch
DynaMed Editorial Team. Vesicoureteral reflux. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated July 2010. Accessed July 13, 2010.
Children’s Hospital Boston. Vesicoureteral reflux. Children’s Hospital Boston website. Available at: http://www.childre... . Accessed June 29, 2010.
Cincinnati Children’s. Vesicoureteral reflux (VUR). Cincinnati Children’s website. Available at: http://www.cincinn... . Accessed June 29, 2010.
Lyons S. Vesicoureteral reflux. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/ . Updated November 30, 2009. Accessed June 29, 2010.
Valla JS, Steyaert H, Griffin SJ, et al. Transvesicoscopic Cohen ureteric reimplantation for vesicoureteral reflux in children: a single-centre 5-year experience. J Pediatr Urol . 2009;5(6):466-71.
Last reviewed June 2012 by Kari Kassir, MD
Last Updated: 06/06/2012