Vesicoureteral Reflux (VUR) | Frequently Asked Questions

Can vesicoureteral reflux be prevented?

No. However, the urinary tract infections that are often associated with vesicoureteral reflux (VUR) can be prevented with changes to toileting behaviors, management of constipation and preventive antibiotics.

Is vesicoureteral reflux inherited?

Yes, VUR is more common in family members of people with VUR. For this reason, you should discuss with your doctor whether siblings or other family members should be tested for VUR.

How often do children with vesicoureteral reflux need to be seen?

We usually see patients with VUR every six to 12 months. Infants may be seen more often. For children with persistent VUR, we recommend VUR testing every year to two years, depending on the child's age.

What do parents of a child with vesicoureteral reflux need to look out for?

The most important issue for children with VUR is a urinary tract infection (UTI). Kidney infections can cause kidney damage, so parents need to watch for signs of UTI. In young children, this usually means a fever. Other signs of UTI include foul-smelling urine, pain with urination, blood in the urine, increased frequency of urination or wetting accidents, or flank and abdominal pain.

Is surgery mandatory?

Many children with VUR will outgrow the condition on their own. Therefore, we do not perform surgery as initial treatment in most children. Some children, however, will require surgery to correct VUR. The most common reasons for proceeding with surgical correction of VUR are repeated UTI with kidney involvement, failure of VUR to resolve on its own over time or severe VUR that is very unlikely to resolve.

If surgery is recommended, what should we expect?

During the open ureteral reimplantation, the surgeon makes an incision in the lower abdomen and exposes the bladder. The junction of the bladder and the ureter (the tube connecting the bladder to the kidney) is reconstructed to prevent urine from flowing backwards up into the kidney. A catheter is left in the bladder to drain the urine for the first one to two days after surgery.

Are antibiotics safe to take for a long time?

Yes. The preventive antibiotics used are given once a day and are very low dose. There are some risks associated with any medication, but we believe that the benefits of preventing UTI (and kidney scarring) in children with VUR outweigh any small risks associated with taking the antibiotics for long periods. We have treated thousands of children with preventive antibiotics for many years with very few severe side effects.

Do children become “immune” to the antibiotics?

Children do not become “immune” to antibiotics. Their immune systems (the germ-fighting and infection-fighting systems) remain fully functional and aren’t altered by being on these medications. Children can still fight off infections normally. However, the bacteria (germs) living on and inside of human beings can become resistant to certain antibiotics through chronic or ongoing exposure.

This problem is minimized by properly selecting the best antibiotic medicines for UTI prevention, using a very low dose and giving it only once a day. Resistance to antibiotics is a major concern in health care and is being studied carefully.

If my child has vesicoureteral reflux, what type of follow up is needed?

Your doctor often will use ultrasound to follow your child’s kidney growth and health. We perform special tests to check for VUR every one to two years. In some cases, VUR can result in scarring in the kidney, which can lead to high blood pressure. Children with scars in their kidneys should have their blood pressure and urine checked every six months, even if their VUR has gone away.