Vesicoureteral Reflux and Urinary Tract Infections in Children

Vesicoureteral reflux (VUR) is the backward flow of urine from the bladder into the kidneys. Normally, urine flows from the kidneys through the ureters to the bladder. The muscles of the bladder and ureters and the pressure of urine in the bladder prevent urine from flowing backward through the ureters.

Reflux causes an abnormal amount of urine to remain in the bladder, which makes it easier for bacteria to grow and reach the kidneys. Vesicoureteral reflux is present in about one-third of children with urinary tract infections (UTIs).¹ It can lead to kidney damage and scarring.

Treatment of reflux depends on how bad the problem is.

• Mild or moderate vesicoureteral reflux in children often improves with age. The doctor may prescribe antibiotics to prevent kidney infections until reflux is no longer a problem.
• When severe reflux is present, reflux has caused kidney damage, or UTIs continue to occur despite preventive treatment with antibiotics, the doctor may recommend surgery to correct vesicoureteral reflux. But surgery may not be any better at preventing future UTIs or kidney damage. And many cases of vesicoureteral reflux get better on their own as a child gets older.²

References

Citations

1. Tanagho EA, Nguyen HT (2008). Vesicoureteral reflux. In EA Tanagho, JW McAninch, eds., Smith's General Urology, 17th ed., pp. 179–192. New York: McGraw-Hill.

2. Larcombe J (2010). Urinary tract infection in children, search date July 2009. Online version of BMJ Clinical Evidence: http://www.clinicalevidence.com.

Credits

By	Healthwise Staff
Primary Medical Reviewer	Susan C. Kim, MD - Pediatrics
Specialist Medical Reviewer	Avery L. Seifert, MD - Urology
Last Revised	March 10, 2011