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Pediatric Vesicoureteral Reflux (VUR)

Backflow of urine from the bladder to the ureter; may be associated with recurrent urinary tract infections and renal damage.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Çocuk Sağlığı ve Hastalıkları department. Book Appointment →

What is Pediatric Vesicoureteral Reflux (VUR)?

Vesicoureteral reflux is abnormal backward flow of urine from the bladder to the ureter and kidney. It can be primary (insufficiency of the physiologic valvular mechanism at the ureterovesical junction) or secondary (bladder outlet obstruction, neurogenic bladder).

Diagnosis is made by VCUG (voiding cystourethrography) and graded into five categories: Grade I (ureter only), II (ureter, pelvis, and calyces without dilatation), III (mild dilatation), IV (moderate dilatation), V (severe dilatation and tortuous ureter).

Treatment is individualized by grade, age, sex, and renal function. Low-grade reflux may resolve spontaneously, so observation may suffice. Prophylactic antibiotics are used in moderate reflux; surgery (endoscopic submucosal injection, ureteral reimplantation) is considered for high-grade or recurrent UTI.

Symptoms

Recurrent febrile UTIs
Pyelonephritis episodes
History of antenatal hydronephrosis
Failure to thrive
Hypertension
Renal scarring and CKD
Voiding dysfunction

Risk Factors

Family history of VUR
Female sex
Antenatal hydronephrosis
Bladder–bowel dysfunction
Neurogenic bladder
Posterior urethral valves

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Recurrent UTIs in a child
  • For radiologic evaluation after a febrile UTI
  • Postnatal follow-up of antenatal hydronephrosis
  • Poor growth or hypertension
  • UTI accompanied by toilet-training problems

Treatment Methods

01
Ultrasound and DMSA scintigraphy
02
Definitive grading with VCUG
03
Observation and bladder–bowel training in low grades
04
Prophylactic antibiotic therapy (trimethoprim, nitrofurantoin)
05
Endoscopic submucosal injection (Deflux)
06
Ureteral reimplantation surgery

Which Department to Visit?

You can visit our Çocuk Sağlığı ve Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Çocuk Sağlığı ve Hastalıkları Department

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You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.