What is vesicoureteric reflux (VUR)?

Vesicoureteric reflux (VUR) is a urinary tract condition in which urine flows backward from the bladder into one or both ureters and sometimes up to the kidneys. Normally, urine travels one way—from the kidneys to the bladder—through a valve-like mechanism at the junction of the ureter and bladder. In VUR, this mechanism fails, increasing the risk of urinary tract infections (UTIs) and potential kidney damage.

VUR is most commonly diagnosed in infants and young children, often after a febrile urinary tract infection. It may be primary, caused by a congenital abnormality of the ureter-bladder junction, or secondary, resulting from increased bladder pressure due to conditions such as bladder outlet obstruction or neurogenic bladder.

The severity of VUR is graded from I to V. Lower grades involve mild backflow into the ureter, while higher grades allow urine to reach and dilate the kidney, posing a greater risk of renal scarring. Repeated UTIs in children with untreated or severe VUR can lead to long-term complications such as hypertension and chronic kidney disease.

Symptoms of VUR itself are often absent, and the condition is usually suspected following recurrent UTIs, poor growth, fever, or abdominal pain in children. Diagnosis may involve ultrasound imaging, voiding cystourethrogram (VCUG), or nuclear scans to assess kidney function and reflux severity.

Management depends on the child’s age, reflux grade, infection history, and kidney health. Mild cases may resolve spontaneously as the child grows and are managed with observation and preventive antibiotics. More severe or persistent cases may require surgical intervention to correct the reflux and protect kidney function.

With early diagnosis, regular monitoring, and appropriate treatment, most children with vesicoureteric reflux achieve good outcomes and maintain normal kidney health into adulthood.