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What is vesicoureteral reflux? — Vesicoureteral reflux 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." It then flows from the bladder out of the body. In children with vesicoureteral reflux, some of the urine flows backward from the bladder through the ureters to the kidneys (figure 1). This can happen in one 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 vesicoureteral reflux? — There are no symptoms.
Why would a doctor think my child has vesicoureteral reflux? — Doctors sometimes think a child might have vesicoureteral reflux if the child has one of the following conditions:
●Hydronephrosis – This condition causes 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 vesicoureteral reflux.
●Urinary tract infection (or "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 vesicoureteral reflux. If both conditions occur together, infected urine could flow backwards to the kidney and cause damage.
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 the child's bladder. Next 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. X-rays taken during this test show if the urine is flowing the wrong way.
How is vesicoureteral reflux treated? — Most of the time, vesicoureteral reflux 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 urinary tract infections. 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.
Patient education: Prenatal hydronephrosis (The Basics)
Patient education: Urinary tract infections in children (The Basics)
Patient education: Urinary tract infections in children (Beyond the Basics)
