Vesicoureteral Reflux

Vesicoureteral Reflux

Signs and Symptoms
Diagnosis
Treatment

Signs and Symptoms

Vesicoureteral reflux is the abnormal backflow of urine from the bladder into the ureter, one of the two tubes that drain urine from the kidneys to the bladder, and up to the kidney. It is the most common problem found in children with urinary tract infections. Reflux is found in 20 percent to 50 percent of children who have had a urinary tract infection. It is dangerous because it allows bacteria that might be in the bladder to reach the kidney. This can cause a kidney infection or pyelonephritis, which can lead to kidney scarring or other damage.

Normally, the ureter enters the bladder in such a way that urine isn't allowed to back up to the kidney. Reflux occurs when the ureter enters the bladder abnormally. The problem results because the muscle backing of the bladder doesn't completely cover the ureter and urine flows back toward the kidney.

Reflux or backflow also occurs because of other problems such as dysfunctional voiding, neurogenic problems or problems with nerve tissue in the bladder or other secondary causes.

We don't know how reflux is transmitted, but there is a very high rate of reflux among siblings - about 40 percent. Younger siblings are at a much greater risk than older siblings. The fact that many affected siblings have no history of urinary tract infection symptoms - although evidence of infection may be found on investigation -- suggests that there may be two different disease processes at work. We recommend that young siblings of refluxers be screened for reflux.

Reviewed by health care specialists at UCSF Children's Hospital.
Last updated March 16, 2009