Vesicoureteral reflux and urinary tract infections in children

Vesicoureteral reflux (VUR) is the backward flow of urine from the bladder into the kidneys. Normally, urine flows from the kidneys through the ureters to the bladder, and the muscles of the bladder and ureters and the pressure of urine in the bladder prevent urine from flowing backward through the ureters. Reflux causes an abnormal amount of urine to remain in the bladder, which makes it easier for bacteria to grow and reach the kidneys. Vesicoureteral reflux is present in almost one-third of children with urinary tract infections (UTIs).¹ It can lead to kidney damage and scarring.

Treatment of reflux depends on the severity of the problem.

• Mild or moderate vesicoureteral reflux in children often improves with age. The doctor may prescribe antibiotics to prevent kidney infections until reflux is no longer a problem.
• When severe reflux is present, reflux has caused kidney damage, or UTIs continue to occur despite preventive treatment with antibiotics, the doctor may recommend surgery to correct vesicoureteral reflux. Surgery can end reflux, but it may not prevent future UTIs.²

Citations

1. Santen SA, Altieri MF (2001). Pediatric urinary tract infection. Emergency Medicine Clinics of North America, 19(3): 675–690.

2. Larcombe J (2006). Urinary tract infection in children. Clinical Evidence (15): 528–539.