Vesicoureteral Reflux (VUR)

Vesicoureteral reflux (VUR) is a medical condition where urine flows retrograde, or backward, from the bladder into the ureters and sometimes to the kidneys. This can increase the risk of urinary tract infections (UTIs) and potentially cause kidney damage over time.

Causes and Risk Factors

VUR can be caused by a variety of factors, including:

• Abnormalities in the ureterovesical junction (UVJ), where the ureters connect to the bladder
• Weakness or dysfunction of the ureteral sphincter muscles
• Neurogenic bladder, a condition where the nerves that control the bladder are damaged
• Congenital conditions, such as prune belly syndrome or ectopic ureters
• Family history of VUR

Symptoms

Symptoms of VUR may include:

• Recurring UTIs
• Painful urination (dysuria)
• Frequent urination (urinary frequency)
• Bedwetting (nocturnal enuresis) in children
• Abdominal pain or flank pain

Diagnosis

VUR is typically diagnosed using a combination of the following tests:

• Voiding cystourethrogram (VCUG), a type of X-ray that uses contrast dye to visualize the bladder and ureters during urination
• Radiographic imaging, such as ultrasound or computed tomography (CT) scans, to evaluate kidney function and detect any abnormalities
• Urinalysis and urine culture to check for UTIs

Treatment and Management

Treatment for VUR depends on the severity of the condition and may include:

• Antibiotic prophylaxis, or preventive antibiotics, to reduce the risk of UTIs
• Behavioral modifications, such as double voiding (urinating twice in a row) and avoiding constipation
• Surgical intervention, such as ureteral reimplantation or endoscopic injection of bulking agents, to correct anatomical abnormalities

Complications and Prognosis

If left untreated or poorly managed, VUR can lead to complications such as:

• Recurring UTIs and pyelonephritis (kidney infection)
• Kidney scarring and damage
• Hypertension and renal failure in severe cases

With proper treatment and management, many individuals with VUR can lead normal lives and avoid long-term complications.