Vesicoureteral reflux (VUR)

Vesicoureteral reflux (VUR) can only be diagnosed by a test called a cystogram, in which a catheter is placed in the bladder and the bladder filled with fluid. This allows your doctors to see the reverse flow of urine toward the kidney.

This type of test is most commonly done in a child who has had a UTI, but may also be performed in infants who have hydronephrosis (fluid on the kidneys) detected by ultrasound before birth.

If you have a family history of VUR, but your child has no symptoms, your child's physician may elect to perform a diagnostic test to rule out VUR. Some of the tests that are used in children with VUR may include:

• Voiding cystourethrogram (VCUG): A specific x-ray test that examines your child’s urinary tract. The bladder is filled with contrast using a catheter, and x-ray picture are taken. The images will show if there is any reverse flow of urine into the ureters and kidneys (VUR).

• Radionuclide cystogram (RNC): An RNC is similar to a VCUG except a different fluid is used to highlight your child’s urinary tract.

• Renal ultrasound: The test is used to determine the size and shape of your child’s kidneys, and to detect scars, kidney stones, cysts or other obstruction or abnormalities.

• DMSA renal scan: A test that provides very detailed information about the shape and condition of the kidneys, including scars and function.

• Urodynamics: Some children with VUR will have their bladder function tested by measuring bladder volume, pressure and emptying. It is performed to determine how a child’s bladder function may be contributing to her VUR.

• Blood tests: To see how well your child’s kidneys are working.

• Urinalysis and urine culture:  Laboratory tests that examine the urine. These tests can indicate microscopic blood or protein in the urine, other chemicals, or evidence of a UTI. In young children who are not toilet trained, the urine may sometimes be collected with a catheter to ensure that the sample is clean and pure.

• VUR Resolution rate calculator: Unique to Children’s Hospital Boston, this is an online tool that can help predict your child’s chance of resolving VUR. By entering in your child’s characteristics, the calculator will provide a probability that your child’s VUR will resolve on its own, without surgery.