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Vesicoureteral reflux (VUR) is a condition where urine in the bladder flows in the wrong direction. It goes up into the tubes (ureters) that lead to the kidneys. It often flows all the way back up to the kidneys.
Normally urine flows down from the kidneys through the ureters to the bladder. The bladder is the organ that stores urine before it leaves the body during urination. The bladder has 3 small openings. The 2 openings at the top connect the ureters to the bladder. The opening at the bottom leads from the bladder to a tube called the urethra. Urine exits the body through the urethra.
The ureters have a 1-way valve system that normally stops urine from flowing back up to the kidneys. When a child has vesicoureteral reflux, this valve system doesn’t work. Urine can then flow backward (reflux) into the ureters and may enter the kidneys.
This condition is most often diagnosed in infancy and childhood.
There are many reasons why a child may develop VUR. Some of the more common causes include:
A child is more at risk for vesicoureteral reflux if he or she has parents or siblings with VUR. In infancy, the disease is more common among boys. This is because when they urinate there is more pressure in their whole urinary tract. In early childhood, VUR is more common in girls. It is more common in white children than in African-American children.
Symptoms can occur a bit differently in each child. They can include:
The symptoms of VUR can be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.
VUR can often be found by ultrasound before a child is born. Sometimes there may be a family history of VUR, but a child has no symptoms. In those cases, a healthcare provider may want to do a test to check for VUR. Tests for VUR include:
Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.
VUR can be mild or more serious. It can cause mild reflux, when urine backs up only a short distance in the ureters. Or it can cause severe reflux leading to kidney infections and permanent kidney damage. Your child's healthcare provider may assign a grade from 1 to 5 to show the degree of reflux. The higher the grade, the more severe the reflux.
Treatment depends on the grade of reflux:
New treatments are being introduced for VUR. Talk with your child's healthcare provider for more information.
A child who has VUR is at risk for repeat kidney infections. Over time, this can cause damage and scarring to the kidneys.
Call your child’s healthcare provider if your child has:
Tips to help you get the most from a visit to your child’s healthcare provider:
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