Vesicoureteral Reflux

Vesicoureteral Reflux

Signs and Symptoms
Diagnosis
Treatment

Treatment

Reflux is treated either with medication or surgery, based on the degree of reflux, the child's age, the number and severity of urinary tract infections, and the amount of damage to the kidneys seen on X-ray studies. As part of treatment, your child will receive an antibiotic in a daily low dose. These antibiotics are very specific for the urinary tract and have very few side effects. The specific type of antibiotic will depend upon your child's age and allergies.

Medical Therapy

Medical therapy is based on the knowledge that most reflux will resolve on its own as the child grows. It requires daily, low-dose antibiotics taken orally. An ultrasound and cystogram of the kidneys will be performed annually to see if the reflux has resolved. If the reflux persists for several years without change in the grade, surgery may be considered. If your child continues to have fever-causing urinary tract infections while taking antibiotics, then surgery should be considered. Again, the goal is to prevent potential scarring or damage from each infection.

Surgical Therapy

Surgery would be performed if your child has a higher grade of reflux, fever-causing urinary tract infections despite being on antibiotics and signs of kidney damage due to repeated infections. Surgery also may be discussed when, after repeated VCUGs, your child's condition doesn't improve over time. In the surgical procedure, the refluxing ureter or urinary tube is repositioned or re-implanted in the bladder wall. The end of the ureter is surrounded by bladder muscle in this new position in the bladder, which prevents urine from "backing-up" or refluxing toward the bladder. Your child will be in the hospital for three to four days. He or she will still need to take daily antibiotics following the surgery until the bladder and ureter are healed. An ultrasound will be performed about a month after surgery. A VCUG may be performed six months following surgery.

Reviewed by health care specialists at UCSF Children's Hospital.
Last updated May 8, 2007