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Patient education: Vesicoureteral reflux in adults (The Basics)

Patient education: Vesicoureteral reflux in adults (The Basics)

What is vesicoureteral reflux? — Vesicoureteral reflux is a condition that causes some urine to flow in the wrong direction inside the body.

All the organs that handle urine are called the "urinary tract" (figure 1). Normally, urine that the kidneys make flows to the bladder through tubes called "ureters." It then flows from the bladder out of the body. But in people with vesicoureteral reflux, some of the urine flows backward from the bladder through the ureters to the kidneys. 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 causes vesicoureteral reflux? — Vesicoureteral reflux is caused by problems with the ureters or bladder. Most of the time, people are born with these problems. But the problems might not be found until the person is an adult. Other times, people who weren't born with vesicoureteral reflux get it later in life because of different conditions that affect the urinary tract.

What are the symptoms of vesicoureteral reflux? — There are no symptoms. But some people get frequent urinary tract infections (or "UTIs"). If you have a UTI, you might have symptoms such as pain or burning when you urinate and needing to urinate often.

Why would a doctor think I have vesicoureteral reflux? — Your doctor might think you have vesicoureteral reflux for different reasons, including:

Frequent UTIs – Urinary tract infections are usually caused by bacteria in the bladder or kidneys. If you get UTIs often, your doctor might want test you for vesicoureteral reflux. If you have both conditions at the same time, infected urine could flow backwards to the kidney and cause damage.

Abnormal findings on an imaging test – People get imaging tests that take pictures of the inside of the body for different reasons. These tests include ultrasounds and MRIs. If some part of your urinary tract does not look normal on one of these tests, your doctor might want to test you for vesicoureteral reflux.

High blood pressure – High blood pressure is very common, especially in older people and people who are overweight. It usually has nothing to do with vesicoureteral reflux, but in a few people, the 2 conditions are related. If your doctor thinks your high blood pressure is not caused by the usual problems, they might want to test you for vesicoureteral reflux.

Kidney disease – Some people with kidney disease also have vesicoureteral reflux.

Is there a test for vesicoureteral reflux? — Yes, there is a test called a "voiding cystourethrogram" or "VCUG." For this test, the doctor puts a small, flexible tube inside your bladder. Next, the doctor fills the bladder with a special fluid that shows up on X-rays. You then urinate while an X-ray is taken. X-rays taken during this test show if the urine is flowing the wrong way.

How is vesicoureteral reflux treated? — Treatments include:

Antibiotics – Your doctor might want you to take antibiotics every day, but at a lower dose than if you really had an infection. These medicines can help keep you from getting a urinary tract infection.

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

More on this topic

Patient education: Urinary tract infections in adults (The Basics)
Patient education: Neurogenic bladder in adults (The Basics)

Patient education: Urinary tract infections in adolescents and adults (Beyond the Basics)

This topic retrieved from UpToDate on: Jan 02, 2023.
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