| Urine normally flows in one direction -- down
from the kidneys, through tubes called ureters, to the bladder.
Vesicoureteral reflux (VUR) is the abnormal flow of urine from the bladder
back into the ureters.
VUR is most commonly diagnosed in infancy and childhood after the
patient has a urinary tract infection (UTI). About one-third of children
with UTI are found to have VUR. VUR can lead to infection because urine
that remains in the child's urinary tract provides a place for bacteria to
grow. But sometimes the infection itself is the cause of VUR.
There are two types of VUR. Primary VUR occurs when a child is born
with an impaired valve where the ureter joins the bladder. This happens if
the ureter did not grow long enough during the child's development in the
womb. The valve does not close properly, so urine backs up (refluxes) from
the bladder to the ureters, and eventually to the kidneys. This type of
VUR can get better or disappear as the child gets older. The ureter gets
longer as the child grows, which improves the function of the valve.
Secondary VUR occurs when there is a blockage anywhere in the urinary
system. The blockage may be caused by an infection in the bladder that
leads to swelling of the ureter. This also causes a reflux of urine to the
kidneys.
Infection is the most common symptom of VUR. As the child gets older,
other symptoms may appear, such as bedwetting, high blood pressure,
protein in the urine, and kidney failure.
Common tests to show the presence of urinary tract infection include
urine tests and cultures. Pictures of the urinary system (cystourogram)
may then be needed to determine whether a defective structure in the
urinary tract is the underlying cause of the VUR and infection.
The goal for treatment of VUR is to prevent any kidney damage from
occurring. Infections should be treated at once with antibiotics to
prevent the infection from moving into the kidneys. Antibiotic therapy
usually corrects reflux caused by infection. Sometimes surgery is needed
to correct primary VUR.
More information is available from
American Foundation for Urologic Disease
1128 North Charles
Street
Baltimore, MD 21201
Phone: 1-800-242-2383 or (410)
468-1800
Email: admin@afud.org
Internet: http://www.afud.org/
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