Vesicoureteral Reflux (VUR) Treatment in Delhi & Gurgaon
Understanding diagnosis, treatment, and management of urinary reflux in children
Illustration showing Vesicoureteral Reflux
What is Vesicoureteral Reflux (VUR)?
Vesicoureteral reflux (VUR) is a condition where urine flows in the wrong direction - backward from the bladder into the ureters and sometimes kidneys.
Your urinary tract is typically a one-way valve, with pee flowing down your urinary tract. This valve-like mechanism prevents pee from going back up into your ureters after it gets to your bladder. Typically, pee should flow like this:
Kidneys
Produce urine. Typically, you have two kidneys.
Ureters
Two thin, muscular tubes that carry urine from kidneys to bladder.
Bladder
Holds or stores urine. It can expand like a balloon.
Urethra
Opening where urine leaves the body.
Important: VUR mostly affects newborns, infants and young children ages 2 and under, but older children and (rarely) adults can also have VUR. Pee flowing the wrong way can cause bacteria to get into your child's kidneys and cause infection, which can lead to permanent kidney damage when left untreated.
Types of Vesicoureteral Reflux
Primary VUR
Most common type (majority of cases)
- Born with ureter that doesn't connect properly to bladder
- Flap valve between ureter and bladder wall doesn't close correctly
- Often unilateral (affects one side)
- May improve as child grows and organs mature
Secondary VUR
Caused by blockage or nerve problems
- Blockage in urinary tract increases pressure
- Problem with nerves that stimulate bladder
- Often bilateral (affects both sides)
- Requires treating underlying cause
Note: VUR that affects only one ureter and kidney is called unilateral reflux. VUR that affects both ureters and kidneys is called bilateral reflux.
Stages of Vesicoureteral Reflux (VUR)
The stages of VUR are grades and there are five of them. Five is the most severe form of VUR and one is the mildest form. The grading system is based on:
Grade 1
Urine goes backward up into a ureter, but the ureter is a normal width.
Grade 2
Urine backs up into a ureter and the kidney pelvis. Both are normal width.
Grade 3
Ureter, kidney pelvis and calyces are mild to moderately enlarged.
Grade 4
Ureters curved and moderately widened; kidney pelvis and calyces moderately widened.
Grade 5
Ureters extremely distorted and enlarged. Kidney pelvis and calyces very large.
Symptoms and Causes
Key Symptom: Urinary Tract Infection (UTI)
In many cases, a child with VUR has no symptoms. When symptoms are present, the most common is a urinary tract infection (UTI). Some estimates show that 30% to 50% of children with a UTI have VUR.
- Needing to pee more often
- Burning or pain when peeing
- Pain in abdomen or lower back
- Only peeing a few drops at a time
- Cloudy or foul-smelling urine
- Infants: fussiness, poor appetite
Risk Factors
Genetic Risk Factors
Sibling with VUR: Little more than 1 in 4 chance sibling will also have VUR
Parent with VUR: 1 in 3 chance child will also have VUR
Complications
Common Complications
- Urinary tract infections (UTIs)
- Bladder problems (incontinence, bedwetting)
- High blood pressure
Kidney Complications
- Kidney scarring
- Kidney damage (nephrotic syndrome)
- Chronic kidney failure (rare)
Good news: Most children with VUR recover without long-term complications with proper treatment and monitoring.
Statistics
of children have VUR
of children with VUR are female
of children with UTI have VUR
Treatment Approach
Mild Cases (Grades 1-2)
- • May not need treatment
- • Many children outgrow VUR
- • Regular monitoring
- • Preventive antibiotics sometimes used
Severe Cases (Grades 3-5)
- • May need surgery to correct valve
- • Endoscopic injection therapy
- • Ureteral reimplantation surgery
- • Medications to prevent infections
Treatment depends on severity of symptoms, child's age, grade of reflux, and other individual factors. Early diagnosis and appropriate management can prevent kidney damage.