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Overview
If your child has a condition known as vesicoureteral reflux (VUR), there are treatments that can help. In this page, you'll learn about VUR and how it can be treated.
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Q1. What is vesicoureteral reflux (VUR)?
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Q2. What causes VUR?
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Q3. Is VUR serious?
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Q4. How can VUR be detected?
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Q5. Who should be tested?
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Q6. Is VUR inherited?
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Q7. Why should VUR be treated?
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Q8. How do I know if my child has VUR?
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Q9. How can VUR be treated?
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Q10. How do I decide what is the right treatment for VUR?
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Q11. Is follow-up required?
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| Q1. |
What is vesicoureteral reflux (VUR)? |
| A1. |
Urine is made in the kidneys. Normally, it only flows one way – down the ureters and into the bladder. VUR occurs when urine
flows back to a kidney from the bladder, through the ureters. This can happen on either or both sides. |
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| Q2. |
What causes VUR? |
| A2. |
About 1% of children in the world have VUR. It results when the connection between the bladder and the ureter is not normal. The lower part of the ureter tunnels through the muscle of the bladder (valve mechanism). If this tunnel is too short, VUR occurs.
Behaviours such as infrequent or incomplete urination and related constipation are also associated with VUR. |
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| Q3. |
Is VUR serious? top |
| A3. |
Your doctor can tell you how serious your child's VUR is, with a grading scale that is obtained by performing an MCU. This scale ranges from Grade 1 (mild) to Grade 5 (severe). Most of the time, mild VUR will go away by itself.
However, the more severe the VUR, the less likely it will go away on its own.
Table Illustrating the Grading Scale for VUR
VUR can have serious consequences. Kidney infections can occur when infected urine flows back into the kidneys. |
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| Q4. |
How can VUR be detected? |
| A4. |
A test called a micturating cystourethrogram (MCU), that uses x-rays and a special dye, will determine whether or not your child has VUR.
If you had VUR as a child, there is a chance that your children will also have VUR. Furthermore, if one of your children has VUR, his or her brothers and sisters may have it too. For these reasons, it is important to discuss testing options with your child's doctor. |
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| Q5. |
Who should be tested? top |
| A5. |
Any child who has had a urinary tract infection with fever should be considered for testing. Children with frequent urinary tract infections should also be considered for testing. |
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| Q6. |
Is VUR inherited? |
| A6. |
VUR tends to run in families. If a person has VUR, as many as one-third of his siblings will also have it. If a parent has VUR, about half of his or her children will also have it.
The risk of kidney damage is greatest during the first 6 years of life. The goal is to find VUR early and prevent infection that could result in kidney damage. |
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| Q7. |
Why should VUR be treated? |
| A7. |
Treatment of VUR is important to protect the kidneys. Kidney infections may cause damage or scarring in the kidneys. This can result in poor kidney function and high blood pressure. Scarring and function of the kidneys need to be documented by a nuclear isotope renogram (DMSA). |
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| Q8. |
How do I know if my child has VUR? top |
| A8. |
Signs of urinary tract infections include:
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Foul-smelling or cloudy urine
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Fever
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Stomachache
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Backache
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Pain in the side
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A burning sensation or pain when urinating
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Frequent and urgent urination
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Headache
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Vomiting
Infants with infection may not show these signs. Instead, they may feed poorly, have diarrhoea, fever and increased irritability. If there is any question in your mind as to whether your child has VUR, please consult your doctor and have your child's urine checked as children can quickly become very sick. |
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| Q9. |
How can VUR be treated? |
| A9. |
It is important to treat VUR to prevent possible infections and kidney damage. There are three options for managing or treating VUR:
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Antibiotics: may be used to prevent infections until VUR goes away by itself. Children must take the medications every day, and be re-tested for VUR on a regular basis.
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Surgery: can fix the ureters to stop VUR. This type of treatment cures most children.
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In Endoscopic Treatment: a substance is injected where the ureter joins the bladder. |
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| Q10. |
How do I decide what is the right treatment for VUR? top |
| A10. |
You should discuss this in great detail with your doctor. Antibiotics, surgery and endoscopic treatment of VUR are all good choices. Your family's personal views are most important.
Surgery may be favoured if VUR is severe or if there are other related medical conditions.
Some families find it hard to ensure that the child has his or her routine x-ray test and takes the daily medications required for antibiotic treatment. Your concerns or beliefs matter. It is therefore important to discuss them with your doctor.
Please make sure that you understand the risks and benefits of each treatment, as well as the follow-up required for each treatment. |
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| Q11. |
Is follow-up required? |
| A11. |
Regular follow-up visits according to protocol are mandatory. This should be discussed with your doctor.
Diagram Illustrating the Normal Flow of Urine
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