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:
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:
National Kidney Foundation
Urology Care Foundation
BC Health Guide
The Kidney Foundation of Canada: British Columbia Branch
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.
Vesicoureteral reflux. Children’s Hospital Boston website. Available at: http://www.childrenshospital.org/az/Site1962/mainpageS1962P0.html. Accessed June 29, 2010.
Vesicoureteral reflux (VUR). Cincinnati Children’s website. Available at: http://www.cincinnatichildrens.org/health/info/urinary/diagnose/vesicoureteral-reflux.htm. Accessed June 29, 2010.
Vesicoureteral reflux. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 2010. Accessed July 13, 2010.
4/1/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Choosing wisely. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated March 26, 2014. Accessed April 1, 2014.
Last reviewed March 2014 by Kari Kassir, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.