1. Vesicoureteral Reflux A description of this disorder and who usually get it. A brief look at the types, testing and treatment.Category Health Conditions and Diseases vesicoureteral reflux......vesicoureteral reflux (VUR) is the abnormal flow of urine from the bladderback into the ureters. Additional Information on vesicoureteral reflux http://www.niddk.nih.gov/health/kidney/summary/vesico/vesico.htm

Also see: UTI in Children Urine normally flows in one direction down from the kidneys, through tubes called ureters, to the bladder. Vesicoureteral reflux (VUR) is the abnormal flow of urine from the bladder back into the ureters. VUR is most commonly diagnosed in infancy and childhood after the patient has a urinary tract infection (UTI). About one-third of children with UTI are found to have VUR. VUR can lead to infection because urine that remains in the child's urinary tract provides a place for bacteria to grow. But sometimes the infection itself is the cause of VUR. There are two types of VUR. Primary VUR occurs when a child is born with an impaired valve where the ureter joins the bladder. This happens if the ureter did not grow long enough during the child's development in the womb. The valve does not close properly, so urine backs up (refluxes) from the bladder to the ureters, and eventually to the kidneys. This type of VUR can get better or disappear as the child gets older. The ureter gets longer as the child grows, which improves the function of the valve. Secondary VUR occurs when there is a blockage anywhere in the urinary system. The blockage may be caused by an infection in the bladder that leads to swelling of the ureter. This also causes a reflux of urine to the kidneys.

2. Report Of The Management Of Primary Vesicoureteral Reflux In Children American Academy of Pediatrics The Report is available in PDF format from the American Urological Association. http://www.aap.org/policy/primvesreflx.html

Practice Guideline Endorsement Report of the Management of Primary Vesicoureteral Reflux in Children Abstract: The American Academy of Pediatrics endorses and accepts as its policy the Report of the Management of Primary Vesicoureteral Reflux in Children The Report is available in PDF format from the American Urological Association Web site at: http://www.auanet.org/publications/clinical_guidelines/vesi_reflux.pdf The recommendations in this statement do not indicate an exclusive course of treatment or serve as a standard of medical care. Variations, taking into account individual circumstances, may be appropriate. Return to AAP Policy Statements - Table of Contents

3. Digital Urology Journal: Vesicoureteral Reflux VESICOURETERAL. REFLUX. The normal urinary tract is made up of the two kidneys, two ureters, a bladder and a urethra. http://www.duj.com/reflux.html

VESICOURETERAL REFLUX The normal urinary tract is made up of the two kidneys, two ureters, a bladder and a urethra. Each of the kidneys produces urine which flows down through the ureters and into the bladder. Normally, each ureter enters the bladder at an angle that creates a tunnel through the bladder wall muscle. As the bladder fills and during emptying, this tunnel prevents any urine from backing up from the bladder into the ureter. By the end of urination, nearly all the urine has passed from the bladder and out of the body through the urethra. Vesicourteral reflux (VUR) is the congenital condition (children are born with it) in which urine backs up from the bladder and into the ureter toward the kidney. Reflux occurs in varying degrees of severity ranging from Grade I to Grade V, with Grade I being the least severe and Grade V being the most severe. Reflux may be present in one or both ureters. It is more prevalent in girls than boys (2:1). The diagnosis of reflux is made based on radiologic studies of the bladder and kidney and may be discovered in the fetus secondary to hydronephrosis , a swelling of the kidney, on prenatal ultrasound.

4. Vesicoureteral Reflux Hub A brief definition, followed by links to overviews, full text articles, and research studies. http://www.projectlinks.org/reflux

Vesicoureteral reflux is the abnormal flow of urine from the bladder back into the ureters. It is most commonly diagnosed in infancy and childhood after the patient has a urinary tract infection. Infection is the most common symptom of vesicoureteral reflux. As the child gets older, other symptoms may appear, such as bedwetting, high blood pressure, protein in the urine, and kidney failure. Vesicoureteral Reflux by National Kidney and Urologic Diseases Information Clearinghouse - from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Vesicoureteral Reflux from eMedicine Journal - by Jong M Choe, MD, FACS, Director of Continence and Urodynamic Center, Assistant Professor, Department of Surgery, Division of Urology, University of Cincinnati College of Medicine. Vesicoureteral Reflux by Laurence S. Baskin, M.D. - from Pediatric Urology Clinical Program at UCSF. Surgery vs. Medical Management for High Grade Vesicoureteral Reflux - by Matthew Eisenberg, MD., University of Washington. Vesicoureteral Reflux by Jeff Van Beek, M.D.

5. Vesicoureteral Reflux vesicoureteral reflux. What is the normal urinary tract? Diagram of uretertunneling through bladder wall. What is vesicoureteral reflux? http://www.pedisurg.com/PtEduc/Vesicoureteral_Reflux.htm

VESICOURETERAL REFLUX What is the normal urinary tract? The urinary tract consists of the kidneys, ureters, bladder and urethra. The kidneys are the organs that are responsible for filtering waste products from the bloodstream and produce urine continuously. The urine drains down tubes called ureters from the kidneys to the bladder, which normally stores urine and empties intermittently by muscular contraction. The urine exits the bladder through the urethra in a process is called voiding or urination. When the ureter enters the bladder it travels through the wall for a distance creating a tunnel so that a flap valve is created. This valve prevents urine that is in the bladder from backing up and returning into the ureter. Thus, when the bladder fills and later when it squeezes down to empty, back-up (that is, reflux of urine) is prevented because the valve operates in the same way as when you pinch off a soda straw. This valve-like action is important for several reasons: prevents bacteria (that often get into the urine) from getting to the kidneys protects the ureters and kidneys from high pressures generated by the bladder during urination permits removal of all of the stored urine with a single act of urination, because the bladder urine has nowhere to go other than out the urethra

6. PedsUroLogic - Vesicoureteral Reflux vesicoureteral reflux. by. Richard M. Parker, MD. If your child has vesicoureteralreflux urine is moving in the wrong direction http://www.pedsurologic.com/Parker/Pamphlets/VCUReflux/VCUReflux.html

Vesicoureteral Reflux by Richard M. Parker, M.D. If your child has vesicoureteral reflux... urine is moving in the wrong direction, and has backed up from the bladder into the ureters and kidneys. The condition varies in severity, from mild or grade I , with urine backing up into the lower ureter, to severe or grade V , where urine back up into a swollen kidney. Urine is produced in the kidneys and normally flows into the ureters and bladder. Upon urination, it goes through the urethra and is eliminated from the body. A valve mechanism located where the ureter enters the bladder prevents urine from backing up from the bladder into the ureters when the bladder empties. An abnormality in this valve may cause urine to flow back into the ureters. This abnormality is usually the result of a short length of ureter as it goes through the bladder. Reflux is usually a congenital condition (children are born with it). Other less common causes of reflux include blockage to the bladder, abnormal urination with very high pressure within the bladder, dysfunctional voiding, or urinary tract infections Diagnosis requires an x-ray...

7. Vesicoureteral Reflux  What Is Vesicoureteral Reflux A definition of vesicoureteral reflux, the main concerns, prognosis and the use of antibiotic prophylaxis. http://www.kids-urology.com/reflux.html

Vesicoureteral Reflux What is vesicoureteral reflux? Vesicoureteral reflux is the abnormal condition of backwash of urine from the bladder up the ureter(s) towards the kidney(s). Reflux can be primary (related to abnormal anatomic relationship between the ureter and bladder) or secondary (related to abnormal urinating or neurologic abnormalities that affect bladder function). The main concern with reflux is the potential for kidney infections, and ultimately kidney damage, over time if not properly managed. With kidney damage, kidney function can deteriorate and other problems, such as high blood pressure, can develop. In some cases reflux may go away over time, with the chances of this based on the grade of the reflux. Grade 1 reflux is minimal reflux and commonly resolves over time, while grade 5 reflux almost never goes away by itself. In almost all cases, initial management of reflux consists of medical therapy, with the purpose of preventing urinary tract infections while waiting to see if the reflux will resolve. If medical therapy is not effective, or the reflux does not resolve, surgical management becomes an option and may be necessary to correct the reflux and help protect the kidneys. The following are the key components of medical therapy for vesicoureteral reflux 1. Antibiotic prophylaxis

8. Vesicoureteral Reflux, University Of Pittsburgh Medical Center, Pittsburgh, PA, Comprehensive information for patients with vesicoureteral reflux, including information about diagnosing and treating the disease from the health care experts at UPMC Health System. Reflux of urine is one of the more common reasons that children are referred to a pediatric urologist. Reflux simply means http://pediatricurology.upmc.com/VesicoureteralReflux

Reflux of urine is one of the more common reasons that children are referred to a pediatric urologist. Reflux simply means that urine goes backwards in the ureter during urination. Read more UPMC Health System Contact Us Supplemental content provided by HealthGate Data Corp Privacy Policy Terms and Conditions

9. Pediatric Oncall- Vesicoureteral Reflux (VUR) Find out more about vesicoureteral reflux and answers to commonly asked questions. http://www.pediatriconcall.com/forpatients/CommonChild/vur.asp

Pediatricians Group Discussion Specialist Answers Share experience ... Doctors Corner VESICO URETERAL REFLUX (VUR) My daughter aged 5 years gets repeated urinary infections. I have been told that she has VUR. What is VUR? VUR is a short form of vesicoureteral reflux which means that urine from the urinary bladder regurgitates or goes back into the ureters (the tubes that connect kidneys to urinary bladder) instead of flowing out of the urethra (tube that allows flow of urine to the outside form the bladder). In severe cases the urine which is in the bladder reaches back in the kidneys. Why does VUR occur? VUR occurs either as a defect in the development of opening of ureter in the urinary bladder from birth when it is called as primary VUR, or secondary due to the obstruction in the bladder or urethra which causes back pressure and opens the junction/s between bladder and ureters How does my doctor diagnose VUR?

10. Virtual Children's Hospital: Urology: Pediatric Urology: Vesicoureteral Reflux A description of vesicoureteral reflux along with information such as how to tell if your child has this, what it does, if surgery is necessary and the types. http://www.vh.org/Patients/IHB/Uro/Peds/RefluxUreteralReimplant.html

Urology Information About Vesicoureteral Reflux Christopher S. Cooper, M.D., Pediatric Urologist Peer Review Status: Internally Peer Reviewed First Published: January 2000 Last Revised: May 2000 What is reflux? Vesicoureteral reflux describes a condition where the urine goes backwards from the bladder into the tubes ("ureters") that usually bring urine from the kidneys. This occurs when there is an abnormal insertion of the ureter through the bladder wall into the inside of the bladder. Some children with abnormally high pressures in the bladder also have reflux despite a normal insertion of the ureter into the bladder. How do I know if my child has reflux? Many children with reflux will develop a urinary tract infection. As part of the usual evaluation of a child with a urinary tract infection, a special study called a "voiding cystourethrogram" or "VCUG" should be performed. A VCUG is done by placing a catheter in the bladder and filling the bladder with contrast material that can be seen on an X-ray. If the child has reflux the X-ray will show the contrast material move out of the bladder and go up into the ureter (this often happens when the child urinates). About a third of the siblings of a child with reflux will also have reflux. A screening cystogram of siblings is therefore recommended even if they have not had a urinary tract infection. Other children are found to have a dilated kidney on prenatal ultrasound and a VCUG obtained after birth detects reflux. What does reflux do?

11. Vesicoureteral Reflux Common Questions, Quick Answers on VUR http://www.pedscare.com/vesicour.htm

Vesicoureteral Reflux Vesicoureteral reflux is a condition that causes urine to go backwards from the bladder up in to the kidneys. This can be a very silent problem and can lead to permanent kidney damage, hypertension, and kidney failure. When a young infant gets a bladder infection, or when a child gets a kidney infection or recurrent bladder infections, it is important to be sure that your child does not have vesicoureteral reflux or any abnormalities of the structure of the kidneys. One test is a renal ultrasound. This test is not painful and does not involve any x-rays. This test shows the size and shape of the kidneys, and will usually detect any obstruction of the kidneys or abnormalities of kidney structure. When a child has vesicoureteral reflux, it is generally recommended that they receive a preventive antibiotic once a day, and then the voiding cystogram is repeated at intervals until the child outgrows the reflux. Most children outgrow vesicoureteral reflux. If the child is kept infection-free by use of the preventive antibiotics, then there is usually not permanent kidney damage. If your child with vesicoureteral reflux has fever or symptoms of bladder infection even while on preventive antibiotics, it is essential to have a urine culture done to be sure there is no infection.

12. Vesicoureteral Reflux vesicoureteral reflux. What is Vesicouretral Reflux? Urine is wastefluid excreted by the kidneys. Urine passes from kidneys, down http://www.pedsurology.com/vesicour.htm

Vesicoureteral Reflux What is Vesicouretral Reflux? Urine is "waste fluid" excreted by the kidneys. Urine passes from kidneys, down the ureters and into the urinary bladder. The bladder is an elastic muscle that acts as a storage tank. As the bladder fills, its walls relax to hold more urine, and the control (sphincter) muscle remains tight to prevent leakage of urine. Normally, the urine is prevented from going back up the ureters toward the kidneys by a valve where the ureters and bladder meet. When the valve is inadequate and allows urine to flow back up into the ureters, this condition is known as reflux. About one out of three children who have urinary tract infections are found to have reflux. Reflux is a condition people are born with and it tends to run in families. If your child has reflux, other siblings may have a 7 - 43% of having reflux depending on the age of the sib. It may suggest that other family members also be checked for reflux. Is Reflux Dangerous? Most urinary tract infections stay in the bladder. When a child has reflux, the bacteriahave direct access to the kidneys and cause a kidney infection (pyelonephritis). This can result in damage to the kidneys and, in some other children, early onset of hypertension.

13. University Of California Detail of what vesicoureteral reflux is, diagnoses, other tests that may be done, how and why is reflux graded, the causes, treatments and risk factors. http://itsa.ucsf.edu/~uroweb/Uro/clinprograms/vesicoureteralreflux.html

14. Vesicoureteral Reflux A look at the normal urinary tract followed by vesicoureteral reflux, its problems, evaluation, non Category Health Conditions and Diseases vesicoureteral reflux......vesicoureteral reflux. The Normal Urinary Tract. vesicoureteral reflux. The valvesystem at the ureterovesical junction may be abnormal for a few reasons. http://www.urology.med.umich.edu/patients/reflux.html

Vesicoureteral Reflux The Normal Urinary Tract The kidneys filter the blood and extract waste products from the blood to make urine. Urine passes from the kidneys, down the ureters , and into the bladder for storage prior to urination. The ureter enters the bladder wall at an angle so that a flap valve is created. This valve prevents urine that is in the bladder from backing up and returning into the ureter. Thus, when the bladder fills and later when it squeezes down to empty, back-up (reflux) is prevented because the valve operates in the same way as you might step on a straw. This valve-like action creates an important barrier that helps keep the kidneys free of bacteria. Once urine has passed from the upper urinary tract into the bladder, the normal valve not only makes certain that urine does not re-enter the upper tracts but also that the high pressures created at the moment of urination are not transmitted to the kidneys. Another important feature of the competent valve (ureterovesical junction) is that it permits you to remove all of the stored urine from the body with a single act of urination - because the bladder urine has nowhere to go other than out the urethra. Vesicoureteral Reflux The valve system at the ureterovesical junction may be abnormal for a few reasons. In many patients the tunnel of the lower ureter through the muscular wall of the bladder may not be long enough. A ratio of at least 4:1 of tunnel length to ureteral diameter is necessary to assure competence of the valve (this means that the part of the ureter traveling through the wall of the bladder should be at least four times as long as it is wide). For some children, there is a good chance that growth may provide the necessary difference to allow the valve to work.

15. Children's Hospital Boston - Department Of Information on the diagnosis and treatment of vesicoureteral reflux in children provided by the Department of Urology. http://www.childrenshospital.org/urology/reflux.html

The information on this website should not be taken as medical advice, which can only be given to you by your personal health care professional. Updated 03/31/2003

16. Vesicoureteral Reflux - Urological Disorders Health Guide Urological Disorders. vesicoureteral reflux. What is vesicoureteral reflux(VUR)? Vesicoureteral What causes vesicoureteral reflux? There http://www.umm.edu/urology-info/vesicour.htm

Urological Disorders Urogenital Disorders... Analgesic Nephropathy Cystocele ... Site Index Related Resources Within UMM Urology Urological Disorders Vesicoureteral Reflux What is vesicoureteral reflux (VUR)? Vesicoureteral reflux occurs when urine that dwells in the bladder flows back into the ureters and often back into the kidneys. The bladder is the hollow, muscular organ that stores urine before urination occurs. The bladder has three small openings: two connect the ureters where urine is drained down from the kidneys, and one connects the bladder to the urethra where urine exits the body. The ureters are funnel-shaped tubes that carry urine from the kidneys. Ureters enter the bladder at a diagonal angle and have a special one-way valve system that normally prevents urine from flowing back up the ureters in the direction of the kidneys. When a child has vesicoureteral reflux, the mechanism that prevents the back-flow of urine does not work, allowing urine to flow in both directions. A child who has vesicoureteral reflux is at risk for developing recurrent kidney infections, which, over time, can cause damage and scarring to the kidneys. What causes vesicoureteral reflux?

17. Virtual Children's Hospital: Urology: Pediatric Urology: Vesicoureteral Reflux Urology Information About vesicoureteral reflux. Christopher S. Cooper,MD, Pediatric Urologist Peer Review Status Internally Peer http://www.vh.org/pediatric/patient/urology/faq/refluxsurgery.html

Urology Information About Vesicoureteral Reflux Christopher S. Cooper, M.D., Pediatric Urologist Peer Review Status: Internally Peer Reviewed First Published: January 2000 Last Revised: May 2000 What is reflux? Vesicoureteral reflux describes a condition where the urine goes backwards from the bladder into the tubes ("ureters") that usually bring urine from the kidneys. This occurs when there is an abnormal insertion of the ureter through the bladder wall into the inside of the bladder. Some children with abnormally high pressures in the bladder also have reflux despite a normal insertion of the ureter into the bladder. How do I know if my child has reflux? Many children with reflux will develop a urinary tract infection. As part of the usual evaluation of a child with a urinary tract infection, a special study called a "voiding cystourethrogram" or "VCUG" should be performed. A VCUG is done by placing a catheter in the bladder and filling the bladder with contrast material that can be seen on an X-ray. If the child has reflux the X-ray will show the contrast material move out of the bladder and go up into the ureter (this often happens when the child urinates). About a third of the siblings of a child with reflux will also have reflux. A screening cystogram of siblings is therefore recommended even if they have not had a urinary tract infection. Other children are found to have a dilated kidney on prenatal ultrasound and a VCUG obtained after birth detects reflux. What does reflux do?

18. Vesicoureteral Reflux A look at the normal urinary tract followed by vesicoureteral reflux, its problems, evaluation, non operative management, surgical correction and follow up. http://www.um-urology.com/patients/reflux.html

Vesicoureteral Reflux The Normal Urinary Tract The kidneys filter the blood and extract waste products from the blood to make urine. Urine passes from the kidneys, down the ureters , and into the bladder for storage prior to urination. The ureter enters the bladder wall at an angle so that a flap valve is created. This valve prevents urine that is in the bladder from backing up and returning into the ureter. Thus, when the bladder fills and later when it squeezes down to empty, back-up (reflux) is prevented because the valve operates in the same way as you might step on a straw. This valve-like action creates an important barrier that helps keep the kidneys free of bacteria. Once urine has passed from the upper urinary tract into the bladder, the normal valve not only makes certain that urine does not re-enter the upper tracts but also that the high pressures created at the moment of urination are not transmitted to the kidneys. Another important feature of the competent valve (ureterovesical junction) is that it permits you to remove all of the stored urine from the body with a single act of urination - because the bladder urine has nowhere to go other than out the urethra. Vesicoureteral Reflux The valve system at the ureterovesical junction may be abnormal for a few reasons. In many patients the tunnel of the lower ureter through the muscular wall of the bladder may not be long enough. A ratio of at least 4:1 of tunnel length to ureteral diameter is necessary to assure competence of the valve (this means that the part of the ureter traveling through the wall of the bladder should be at least four times as long as it is wide). For some children, there is a good chance that growth may provide the necessary difference to allow the valve to work.

19. Virtual Children's Hospital: CQQA: Visicoureteral Reflux Pediatrics Common Questions, Quick Answers. VUR (vesicoureteral reflux).Donna What is VUR? VUR stands for vesicoureteral reflux. It http://www.vh.org/pediatric/patient/pediatrics/cqqa/vur.html

Pediatrics Common Questions, Quick Answers VUR (Vesicoureteral Reflux) Donna D'Alessandro, M.D. Lindsay Huth, B.A. Peer Review Status: Internally Reviewed Creation Date: February 2002 Last Revision Date: April 2002 Common Questions, Quick Answers What is VUR? What causes it? Who can get it? ... When should I call the doctor? What is VUR? VUR stands for Vesicoureteral Reflux. It is a problem of the urinary tract (system that rids the body of urine). The ureters are the tubes that take urine from the kidneys to the bladder. "Reflux" means "backward flow." VUR is when urine flows backward from the bladder into the ureters instead of through the bladder and out the body. Children are born with this condition. What causes it? In children with VUR, the tubes that connect to the bladder don't work right. The tubes may be too short or the openings may not shut right. Some cases of VUR are caused by high pressure in the bladder. Who can get it? VUR tends to run in families. Children with VUR are likely to have brothers or sisters with VUR. (1 out of 3 of his brothers or sisters is likely to have it.) If a child has VUR, his brothers and sisters should also be tested for it.

20. Pediatric Urology - Vesicoureteral Reflux - Urologychannel vesicoureteral reflux is a pediatric urology disorder. Onethird of UTIs inchildren are caused by vesicoureteral reflux. Causes and Risk Factors. http://www.urologychannel.com/pediatric/vur.shtml

Home Search SiteMap Ask the Dr. ... Medical Store advertisement advertisement PEDIATRIC UROLOGY Overview Antenatal Hydronephrosis Hypospadias Nocturnal Enuresis Undescended Testicle Ureteropelvic Junction Obstruction Vesicoureteral Reflux Treatment CONDITIONS Adrenal Cancer Bladder Cancer Bladder Control Problems BPH/Enlarged Prostate Emergencies Erectile Dysfunction Female Sexual Dysfunction Hematuria Incontinence Interstitial Cystitis Kidney Cancer ... Testosterone Deficiency Upper Tract Tumors Urethral Cancer Urinary Tract Infection Varicocele Vasectomy RESOURCES Anatomy Clinical Trials Education HealthProfiler ... Videos ABOUT US Healthcommunities.com Pressroom Testimonials Overview Vesicoureteral reflux (VUR) is the backup of urine from the bladder (organ that stores urine) into the ureter (tube that carries urine from the kidney to the bladder) during urination. VUR may result in urine reflux into the renal pelvis, (glossary link) causing distention (hydronephrosis) and kidney damage. In children, this condition is usually caused by congenital (present at birth) abnormalities and is often diagnosed during prenatal ultrasound. Types There are two types of VUR: primary and secondary. Primary reflux is caused by a congenital (present at birth) abnormality, and secondary reflux is caused by a urinary tract infection (

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