Vesicoureteral Reflux (VUR)

What is vesicoureteral reflux?

Vesicoureteral reflux (VUR) is the result of abnormal formation of the normal valve between the kidney and bladder. This valve ensures that urine travels one way from the kidney to the bladder. If your child has VUR, the urine does move backward into the ureters and kidney. Some children only have mild VUR, while others have large amounts of urine moving backward into their kidneys.

Although VUR by itself is not usually painful, VUR can become a problem if the child develops a urinary tract infection (UTI) in the bladder. With this type of infection, the bacteria are carried backward from the bladder to the kidneys, and this can result in serious infection and possibly damage to the kidneys.

How common is vesicoureteral reflux?

VUR is a condition that affects about 1 to 3 percent of all children. However, there are certain groups of children in whom VUR is much more common, including:

  • children who have hydronephrosis or excessive fluid in the kidneys. Among this group, VUR is seen in about 15 percent of these children when testing is done after the baby is born.
  • children who have a urinary tract infection, particularly if the infection was associated with a fever. Among this group, VUR is found in 50 to 70 percent of these children.

What are the symptoms of vesicoureteral reflux?

Children who have vesicoureteral reflux (VUR) may not feel sick, because VUR typically does not present symptoms. VUR is most often diagnosed after a child has experienced a urinary tract infection (UTI) accompanied with a fever. Some children are also diagnosed shortly after birth if they had hydronephrosis (fluid in the kidneys) on their prenatal (before birth) ultrasounds.

Common symptoms of UTI in children include:

  • fever
  • pain or burning with urination
  • strong or foul odor to the urine
  • sudden onset of frequent urination or wetting accidents
  • abdominal or flank pain (between the hip and rib)

What causes vesicoureteral reflux?

The cause of VUR is unknown, however there is a strong genetic component. Although no specific genes have been identified, VUR is common among children and siblings of parents with VUR. During infancy, VUR is more frequently in boys. In older children, VUR is more frequently diagnosed in girls.

VUR may also occur as a result of these less common issues:

How we care for vesicoureteral reflux

The Boston Children’s Hospital Department of Urology team takes a conservative approach to VUR. Most children will outgrow their VUR on their own, and we give them a chance to do just that.

Our main goal is to treat vesicoureteral reflux (VUR) and prevent infections that might affect the kidneys and possibly cause kidney damage. Our specialists provide a comprehensive approach to the management of vesicoureteral reflux from initial diagnosis to treatment and follow-up care.