Vesicoureteral Reflux -- Adult

Vesicoureteral reflux (VUR) is the backward flow of urine. The urine flows from the bladder back into the kidney. Urine normally flows from the kidneys. It passes through tubes called ureters. It then flows into the bladder. Each ureter connects to the bladder in a way that prevents urine from flowing back up the ureter. The connection is similar to a one-way valve. When this does not work properly, or if the ureters do not extend far enough into the bladder, urine may flow back up to the kidney. If the urine contains bacteria, the kidney may become infected. The back up can also put extra pressure on the kidney. This can cause kidney damage.

  • Causes

    This condition may be caused by:

  • Definition

    Vesicoureteral reflux (VUR) is the backward flow of urine. The urine flows from the bladder back into the kidney.

    Urine normally flows from the kidneys. It passes through tubes called ureters. It then flows into the bladder. Each ureter connects to the bladder in a way that prevents urine from flowing back up the ureter. The connection is similar to a one-way valve. When this does not work properly, or if the ureters do not extend far enough into the bladder, urine may flow back up to the kidney. If the urine contains bacteria, the kidney may become infected. The back up can also put extra pressure on the kidney. This can cause kidney damage.

    Anatomy of the Urinary System
    The Urinary Tract
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  • Diagnosis

    Your doctor will ask about your symptoms and medical history. A physical exam will be done.

    Your bodily fluids may be tested. This can be done with:

    • Blood tests
    • Urine tests
    • Ultrasound

    Images may be taken of your bodily structures. This can be done with:

    • CT scan
    • Voiding cystourethrogram (VCUG)
    • Intravenous pyelogram
    • Nuclear scans

  • Prevention

    VUR cannot be prevented in most cases. However, further complications can be avoided. Seek prompt treatment for bladder or kidney infections. This is particularly important if you have a neurogenic bladder.

  • Risk Factors

    Factors that increase your chance of developing VUR include:

    • Family history
    • Congenital abnormalities of the urinary tract

    • Birth defects that affect the spinal cord, such as
      spina bifida
    • Tumors in the spinal cord or pelvis
    • Spinal cord injury

  • Symptoms


    In most cases, VUR has no obvious symptoms or signs. In some cases, VUR is found after a
    urinary tract
    or
    kidney infection
    is diagnosed. Symptoms of urinary tract infections include:

    • Frequent and urgent need to urinate
    • Passing small amounts of urine
    • Pain in the abdomen or pelvic area
    • Burning sensation during urination
    • Cloudy, bad-smelling urine
    • Increased need to get up at night to urinate
    • Blood in the urine
    • Leaking urine
    • Low back pain or pain along the side of the ribs
    • Fever and chills

  • Treatment

    The goal for treatment of VUR is to prevent any permanent kidney damage. Treatment options include the following: