Vesicoureteral reflux is the backward flow of urine from the bladder towards the kidneys. Normally urine travels in one direction only; when it flows back, bacteria in the bladder can reach the kidney and lead to recurrent infections.

When It Comes to Mind

  • Recurrent urinary tract infections
  • A young infant who has had a urinary tract infection with fever
  • Widening of the kidney detected on a prenatal ultrasound
  • A similar history in the family

Symptoms

VUR causes no symptoms on its own; it is usually noticed through an infection: fever, burning when urinating, frequent urination, foul-smelling urine, and in infants restlessness and poor weight gain.

How It Is Diagnosed

The assessment is made by the physician; after a urinalysis and urine culture, an ultrasound and, when needed, a special X-ray taken during voiding may be requested. Which test is required varies with the child's age and clinical picture.

Follow-up and Treatment

The grade of the reflux and the child's age are decisive. In many children the reflux resolves on its own as the child grows; during this period the aim is to protect the kidney from infection. The follow-up plan, the use of preventive medication and, if needed, the decision to intervene are made by the physician.

What Families Should Pay Attention To

Adequate fluid intake, preventing constipation and a regular toilet routine are important in reducing how often infections occur. Constipation can impair bladder emptying and make the picture worse.