The pediatric urologists with Norton Children’s Urology, affiliated with the UofL School of Medicine, are fellowship trained in pediatric and adolescent urology specialty care. They have the expertise to treat urinary reflux in children. The condition, also called vesicoureteral reflux, or VUR, usually is diagnosed in infants and young children. Our specialists bring skill, respect and sensitivity to caring for your child’s urological needs.

What Is Urinary Reflux?

Urine flows from the kidneys to the bladder through tubes called ureters. Urinary reflux causes this flow to be reversed. There are two types of urinary reflux:

• Primary: This is when the condition is present at birth
• Secondary: This is when a child develops the condition later on

Children often outgrow primary urinary reflux as they grow. However, children may develop complications if the condition is not treated.

Urinary Tract Infections and Urinary Reflux

The most common complication is a urinary tract infection (UTI). Signs of a UTI include:

• Frequent urge to urinate
• Burning feeling from urination
• Blood or strong odor in urine
• Loss of bladder control
• Fever
• Pain in the lower back or abdomen

Untreated UTIs can lead to kidney infections, which may cause permanent scarring in the kidneys.

UTIs in infants may be more difficult to notice. Signs of a UTI in an infant include:

• Prolonged fever
• Sluggish behavior
• Diarrhea
• Extended appetite loss
• Vomiting that is either more frequent or forceful than normal spit up

If you believe your baby or child may have a UTI, meet with a health care provider to ensure the condition does not worsen.

Urinary Reflux Risk Factors

Age, assigned gender and family history are three of the most important factors used to determine a child’s risk for developing urinary reflux. Children younger than age 2 are much more likely to have the condition than older children. Primary urinary reflux affects assigned males more, but secondary urinary reflux is more common among assigned females. About 1 in 4 siblings of children with the condition also have it. About 1 in 3 children with the condition have a parent who had it as well.

Urinary Reflux Diagnosis and Treatment

The condition is diagnosed through a test called a voiding cystourethrogram (VCUG). The test can show irregular urine flow through the use of a catheter and X-rays.

Pediatric urologists may recommend the following treatments:

• Antibiotics: Antibiotics help prevent bacteria growth and infection. The medicines do not eliminate urinary reflux, but can keep the child healthy while they outgrow the condition.
• Bulking injections: These injections reinforce the bladder wall to help prevent urine from traveling back up the ureters.
• Behavioral changes: Behavior changes can be effective in preventing UTIs. These changes can include:
  • Drinking more fluids
  • Regular emptying of the bladder
  • Frequent diaper changes to prevent bacteria spread
  • Wiping from front to back
• Surgery: Children with severe or repeated UTIs may need surgery to help strengthen the bladder’s ability to prevent urine from re-entering the ureters and kidneys. While endoscopic and open surgery procedures are options, your child’s pediatric urologist would look at your child’s health history, age and other factors to recommend the best option.