Vesicoureteral Reflux.

Urine normally flows in one direction--down from the kidneys, through tubes called ureters, to the bladder. Vesicoureteral reflux (VUR) is the abnormal flow of urine from the bladder back into the ureters.

VUR is most commonly diagnosed in infancy and childhood after the patient has a urinary tract infection (UTI). About one-third of children with UTI are found to have VUR. VUR can lead to infection because urine that remains in the child's urinary tract provides a place for bacteria to grow. But sometimes the infection itself is the cause of VUR.

There are two types of VUR. Primary VUR occurs when a child is born with an impaired valve where the ureter joins the bladder. This happens if the ureter did not grow long enough during the child's development in the womb. The valve does not close properly, so urine backs up (refluxes) from the bladder to the ureters, and eventually to the kidneys. This type of VUR can get better or disappear as the child gets older. The ureter gets longer as the child grows, which improves the function of the valve.

Secondary VUR occurs when there is a blockage anywhere in the urinary system. The blockage may be caused by an infection in the bladder that leads to swelling of the ureter. This also causes a reflux of urine to the kidneys.

Infection is the most common symptom of VUR. As the child gets older, other symptoms may appear, such as bedwetting, high blood pressure, protein in the urine, and kidney failure.

Common tests to show the presence of urinary tract infection include urine tests and cultures. Pictures of the urinary system (cystourogram) may then be needed to determine whether a defective structure in the urinary tract is the underlying cause of the VUR and infection.

The goal for treatment of VUR is to prevent any kidney damage from occurring. Infections should be treated at once with antibiotics to prevent the infection from moving into the kidneys.

Antibiotic therapy usually corrects reflux caused by infection. Sometimes surgery is needed to correct primary VUR.

More information is available from

American Foundation for Urologic Disease
300 West Pratt Street
Suite 401
Baltimore, MD 21201

Additional Information on Vesicoureteral Reflux

The National Kidney and Urologic Diseases Information Clearinghouse collects resource information on kidney and urologic diseases for the Combined Health Information Database (CHID). CHID is a database produced by health-related agencies of the Federal Government. This database provides titles, abstracts, and availability information for health information and health education resources.

To provide you with the most up-to-date resources, information specialists at the clearinghouse created an automatic search of CHID. To obtain this information you may view the results of the automatic search on Vesicoureteral Reflux.

Or, if you wish to perform your own search of the database, you may access the CHID Online web site and search CHID yourself.

This information is provided by the National Kidney and Urologic Diseases Information Clearinghouse, a service of the National Institute of Diabetes and Digestive and Kidney Diseases.

e-text posted: 3 February 1998