What is vesicoureteral reflux (VUR)?

Under normal circumstances, urine flows from the kidneys to the bladder through tubes called ureters. Vesicoureteral reflux (VUR) is a condition that causes this flow to be reversed. VUR is most commonly diagnosed in infants and young children. It can be classified as either primary, meaning that the condition has been present since birth, or secondary if developed later on. Children often outgrow primary VUR as they age, however, complications can arise if the condition is left untreated.

The most common complication of VUR is a urinary tract infection (UTI). Signs of a UTI include: frequent urge to urinate, a burning feeling from urination, blood or strong odor in urine, loss of bladder control, fever, and pain in the lower back or abdomen. Untreated UTIs can lead to kidney infections, which may cause permanent scarring of the organ.

UTIs can be more difficult to detect in infants, but signs include prolonged fever, sluggish behavior, diarrhea, extended appetite loss, and vomiting that is either more frequent or forceful than normal spitting up. If you believe that your infant or child may have a UTI, meet with a health care provider to ensure that the condition does not worsen.

Diagnosing vesicoureteral reflux

Age, sex, and family history are three of the most important factors used to determine a child’s risk of developing VUR. Children under 2 are much more likely to have VUR than those who are older. Boys  more often have primary VUR, but secondary VUR is more common among girls. About 1 in 4 siblings of children with VUR also have the condition, along with about 1 in 3 who have a parent who’s had VUR.

To diagnose the condition, a test known as a voiding cystourethrogram (VCUG) can detect irregular urine flow through the use of a catheter and X-rays.

How to treat vesicoureteral reflux

Doctors often recommend antibiotics to combat bacteria growth and prevent infection. The treatment does not eliminate VUR, but can keep the child healthy while outgrowing the condition. Bulking injections are another option for treatment. These injections reinforce the bladder wall to help prevent urine from traveling back up the ureters.

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Behavioral changes also can be effective in preventing UTIs. Drinking more fluids, regular emptying of the bladder, frequent changing of diapers to prevent spread of bacteria, and wiping from front to back are strategies that can help patients.

For children with severe or repeated UTIs, surgery may be required to treat VUR. Procedures have the goal of strengthening the bladder’s ability to prevent urine from reentering the ureters and kidneys. While endoscopic and open surgery procedures are options for treatment, a urologist would use specifics of an individual’s case to recommend the best option.


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