(VUR; Reflux Nephropathy; Chronic Atrophic Pyelonephritis; Vesico-Ureteric Reflux; Ureteral Reflux)
Pronounced: VEH-sih-co-ya-REET-uh-rul REE-flux
by Sonja Lyons
Vesicoureteral reflux (VUR) is the backward flow of urine. The urine flows from the bladder back into the kidney.
Urine normally flows from the kidneys. It passes through tubes called ureters. It then flows into the bladder. Each ureter connects to the bladder in a way that prevents urine from flowing back up the ureter. The connection is similar to a one-way valve. When this does not work properly, or if the ureters do not extend far enough into the bladder, urine may flow back up to the kidney. If the urine contains bacteria, the kidney may become infected. The back-up can also put extra pressure on the kidney. This can cause kidney damage.
This is a potentially serious condition that requires care from a doctor. Early treatment and prevention of infections can lead to better outcomes. If you suspect you have this condition, contact your doctor immediately.
This condition may be caused by:
Factors that increase your chance of developing VUR include:
A prenatal ultrasound may show a swelling of the kidneys. This is called hydronephrosis. It may indicate VUR.
Your doctor will ask about your symptoms and medical history. A physical exam will be done. Tests may include:
The goal for treatment of VUR is to prevent any permanent kidney damage. Treatment options include the following:
Endoscopic Injection Into the Ureter
This procedure is a minimally invasive surgery. It is done to correct the reflux. A gel is injected where the ureter inserts into the bladder. This can prevent urine from going back up the ureter. This procedure is done through a small tube called a cystoscope.
This is a surgery that repositions the ureters in the bladder. This can be done in two ways. One way requires making an incision above the pubic bone and repositioning the ureters in the bladder. It can also be done laparoscopically by inserting cameras through small incisions in the abdomen and/or bladder to perform the surgery.
VUR cannot be prevented in most cases. However, further complications can be avoided. Seek prompt treatment for bladder or kidney infections. This is particularly important if you have a neurogenic bladder.
American Urological Association Foundation
National Kidney Foundation
The Kidney Foundation of Canada
Valla JS, Steyaert H, Griffin SJ, et al. Transvesicoscopic Cohen ureteric reimplantation for vesicoureteral reflux in children: a single-centre 5-year experience. J Pediatr Urol . 2009;5(6):466-471.
Vesicoureteral reflux. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated April 26, 2012. Accessed October 18, 2012.
Vesicoureteral reflux. National Kidney and Urological Diseases Information Clearinghouse website. Available at: http://kidney.nidd... . Updated September 2011. Accessed October 18, 2012.
Wein A, ed. Campbell-Walsh Urology . 9th ed. Philadelphia, PA: Saunders, Elsevier; 2007.
Last reviewed October 2012 by Adrienne Carmack, MD