Vesicoureteral reflux (VUR)
Children's has done extensive research into the wide variation in how VUR is treated throughout the country. We have found that how your child's VUR is managed is heavily dependent on where you live and what hospital you're treated at.
Caleb Nelson, MD, MPH, Boston Children's Hospital urologist and Kidney Stone Center co-director
In normal kidney-bladder function, urine flows from the kidneys to the bladder. In children with vesicoureteral reflux (VUR), however, the urine also flows backwards, from the bladder up toward the kidneys. As a result, children with VUR are at risk for kidney infections and may develop kidney damage.
- VUR affects about 1 percent of children.
- Many children will grow out of their VUR as they get older.
- Urine is normally sterile. When bacteria get into the bladder, a urinary tract infection (UTI) may result. In children with VUR, those bacteria can get to the kidneys more easily, resulting in a kidney infection.
- A kidney infection can be a serious illness, with high fever, nausea, vomiting or pain. Kidney infections can also lead to damage (scarring) of the kidney.
- The goal of treatment in children with VUR is to prevent kidney infections and kidney damage.
- To prevent infections in children with VUR, most children take low-dose antibiotics once a day to keep their urine sterile.
- Some children with VUR need surgery to correct the VUR, prevent infection and protect the kidneys.
How Children’s Hospital Boston approaches VUR
We take a conservative approach to VUR here at Children’s. Most children will outgrow their VUR on their own, so we give them a chance to do that. It’s very important that children with VUR be protected from infection, so preventive antibiotics are an essential component of our treatment.
The most common reasons we recommend surgery to correct VUR are:
- continued kidney infections despite preventive antibiotics
- VUR that does not resolve on its own
In the event that surgery is recommended, doctors at Children’s use surgical procedures that we pioneered. Our surgeons have also developed minimally invasive surgical techniques for use with patients with VUR, and procedures such as laparoscopic and endoscopic surgeries may be options.
Children’s researchers have studied the wide variation in how VUR is treated throughout the country. We have found that how your child’s VUR is managed heavily depends on where you live and what hospital you are treated at. Our goal is to treat your child’s VUR based on the best available scientific evidence—not based on tradition or local customs. To help with this, we have developed the VUR Resolution Rate Calculator—unique to Children’s—which can help predict if a child’s reflux will resolve.
|Children's has been ranked first in Urology|
Children's has been ranked first in Urology in U.S.News and World Report's 2010 edition of America's Best Children's Hospitals.
Reviewed by Caleb P. Nelson, MD, MPH
© Children’s Hospital Boston, 2010