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Patient education: Vesicoureteral reflux in children (The Basics)

Patient education: Vesicoureteral reflux in children (The Basics)

What is vesicoureteral reflux? — Vesicoureteral reflux ("VUR") is a condition that causes some urine to flow in the wrong direction inside the body. Normally, urine that the kidneys make flows to the bladder through tubes called "ureters." Then, it flows from the bladder out of the body. In children with VUR, some of the urine flows backward from the bladder through the ureters to the kidneys (figure 1). This can happen in 1 or both of the ureters.

This problem is most common in babies and young children. It often gets better or goes away as the child gets older. But it can also happen in older children and in adults.

What are the symptoms of VUR? — There are no symptoms.

Why would a doctor think my child has VUR? — Doctors sometimes think that a child might have VUR if the child has 1 of the following conditions:

Hydronephrosis – This condition causes a part of the kidney to swell because it has too much urine inside. It can be seen on a routine imaging test (ultrasound) to check on the baby during pregnancy. If an ultrasound done on a baby after delivery shows hydronephrosis, the baby might have VUR.

Urinary tract infection ("UTI") – These infections are usually caused by bacteria in the bladder or kidneys. If a child has had several UTIs, the doctor might want to test them for VUR. If both conditions occur together, infected urine could flow backward to the kidney and cause damage.

Is there a test for VUR? — Yes, there is a test called a "voiding cystourethrogram" ("VCUG"). For this test, the doctor puts a small, flexible tube inside the child's bladder. The doctor fills the child's bladder with a special fluid that shows up on X-rays. Then, the child urinates while on the X-ray table. The X-rays show if the urine is flowing the wrong way.

How is VUR treated? — Usually, VUR goes away on its own without treatment. Your child's doctor will do regular tests to see if this happens.

If treatment is needed, it might include:

Antibiotics – These medicines help prevent UTIs. Children being treated with antibiotics take them every day but at a lower dose than they would if they had an infection.

Surgery – Different kinds of surgery can stop the backflow of urine from the bladder to the kidney.

More on this topic

Patient education: Hydronephrosis in babies (The Basics)
Patient education: Urinary tract infections in children (The Basics)

Patient education: Urinary tract infections in children (Beyond the Basics)

This topic retrieved from UpToDate on: Feb 02, 2024.
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