Testing & Diagnosis for Vesicoureteral Reflux (VUR) in Children

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Vesicoureteral reflux (VUR) can only be diagnosed by a test called a cystogram, in which a catheter is placed through the urethra into the bladder, and the bladder is filled with fluid. This procedure allows your doctors to see the reverse flow of urine toward the kidney. There are 2 types of cystogram:

  • voiding cystourethrogram (VCUG): an x-ray test that examines your child’s urinary tract. The bladder is filled with contrast using a catheter, and x-ray pictures are taken. The images will show if there is any reverse flow of urine into the ureters and kidneys.
  • radionuclide cystogram (RNC): an RNC is similar to a VCUG except a different fluid is used to highlight your child’s urinary tract.

A cystogram is most commonly done in a child who has had a UTI but may also be performed in infants who have hydronephrosis (fluid in the kidneys)—a condition 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.

Other test that are sometimes done in children with VUR include:

  • 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 how well or poorly the kidneys are functioning.
  • 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: These tests determine how well your child’s kidneys are working.
  • urinalysis and urine culture: These laboratory tests examine urine and identify 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.
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