96905 Health Library | Health and Wellness | Wellmont Health System
  • Vesicoureteral Reflux—Adult

    (VUR; Reflux Nephropathy; Chronic Atrophic Pyelonephritis; Vesico-Ureteric Reflux; Ureteral Reflux)


    Vesicoureteral reflux (VUR) is the backward flow of urine. The urine flows from the bladder back into the kidney.
    Urine normally flows from the kidneys. It passes through tubes called ureters. It then flows into the bladder. Each ureter connects to the bladder in a way that prevents urine from flowing back up the ureter. The connection is similar to a one-way valve. When this does not work properly, or if the ureters do not extend far enough into the bladder, urine may flow back up to the kidney. If the urine contains bacteria, the kidney may become infected. The back-up can also put extra pressure on the kidney. This can cause kidney damage.
    This is a potentially serious condition that requires care from a doctor. Early treatment and prevention of infections can lead to better outcomes. If you suspect you have this condition, contact your doctor immediately.
    Anatomy of the Urinary System
    The Urinary Tract
    Copyright © Nucleus Medical Media, Inc.


    This condition may be caused by:
    • A problem in the way the ureter inserts into the bladder
    • A ureter that does not extend far enough into the bladder
    • A bladder outlet obstruction (eg, blockage of urine flow from an enlarged prostate gland)
    • A neurogenic bladder (loss of normal bladder function due to damaged nerves reaching the bladder)
    • Temporary swelling after kidney transplant

    Risk Factors

    Factors that increase your chance of developing VUR include:
    • Family history
    • Congenital abnormalities of the urinary tract
    • Birth defects that affect the spinal cord, such as spina bifida
    • Tumors in the spinal cord or pelvis
    • Spinal cord injury


    In most cases, VUR has no obvious symptoms or signs. In some cases, VUR is found after a urinary tract or kidney infection is diagnosed. Symptoms of urinary tract infections include:
    • Frequent and urgent need to urinate
    • Passing small amounts of urine
    • Pain in the abdomen or pelvic area
    • Burning sensation during urination
    • Cloudy, bad-smelling urine
    • Increased need to get up at night to urinate
    • Blood in the urine
    • Leaking urine
    • Low back pain or pain along the side of the ribs
    • Fever and chills
    A prenatal ultrasound may show a swelling of the kidneys. This is called hydronephrosis . It may indicate VUR.


    Your doctor will ask about your symptoms and medical history. A physical exam will be done. Tests may include:
    • Blood tests
    • Urine tests
    • Ultrasound
    • CT scan
    • Voiding cystourethrogram (VCUG)—a liquid that can be seen on x-rays is placed in the bladder through a catheter; x-rays are taken when the bladder is filled and when urinating.
    • Intravenous pyelogram—a liquid that can be seen on x-rays is injected into a vein; x-ray images are taken as the liquid travels from the blood (after being injected into a vein) into the kidneys and bladder
    • Nuclear scans—a variety of tests using radioactive materials injected into a vein or the bladder to show how well the urinary system is working
    In rare cases, high blood pressure may be an indication of kidney damage.


    The goal for treatment of VUR is to prevent any permanent kidney damage. Treatment options include the following:


    Endoscopic Injection Into the Ureter
    This procedure is a minimally invasive surgery. It is done to correct the reflux. A gel is injected where the ureter inserts into the bladder. This can prevent urine from going back up the ureter. This procedure is done through a small tube called a cystoscope .
    Ureteral Reimplantation
    This is a surgery that repositions the ureters in the bladder. This can be done in two ways. One way requires making an incision above the pubic bone and repositioning the ureters in the bladder. It can also be done laparoscopically by inserting cameras through small incisions in the abdomen and/or bladder to perform the surgery.


    VUR cannot be prevented in most cases. However, further complications can be avoided. Seek prompt treatment for bladder or kidney infections. This is particularly important if you have a neurogenic bladder.


    American Urological Association Foundation http://www.urologyhealth.org/

    National Kidney Foundation http://www.kidney.org/


    Health Canada http://www.hc-sc.gc.ca

    The Kidney Foundation of Canada http://www.kidney.ca/


    Valla JS, Steyaert H, Griffin SJ, et al. Transvesicoscopic Cohen ureteric reimplantation for vesicoureteral reflux in children: a single-centre 5-year experience. J Pediatr Urol . 2009;5(6):466-471.

    Vesicoureteral reflux. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated April 26, 2012. Accessed October 18, 2012.

    Vesicoureteral reflux. National Kidney and Urological Diseases Information Clearinghouse website. Available at: http://kidney.niddk.nih.gov/kudiseases/pubs/vesicoureteralreflux/ . Updated September 2011. Accessed October 18, 2012.

    Wein A, ed. Campbell-Walsh Urology . 9th ed. Philadelphia, PA: Saunders, Elsevier; 2007.

    Revision Information

  • Join WellZones today.

    Make a Change For LifeLearn more

    Wellmont LiveWell is creating a new tradition of wellness in the mountains by providing individuals with tools and encouragement to live healthier lifestyles.

  • HeartSHAPE Spotlight

    At risk for a heart attack? Learn more

    Fight heart disease early and prevent heart attacks with HeartSHAPE® - a painless, non-invasive test that takes pictures of your heart to scan for early-stage coronary disease.

  • Calories and Energy Needs

    Calorie NeedsLearn more

    How many calories do you need to eat each day to maintain your weight and fuel your physical activity? Enter a few of your stats into this calculator to find out.

  • Ideal Body Weight

    Ideal Body WeightLearn more

    Using body mass index as a reference, this calculator determines your ideal body weight range. All you need to do is enter your height.

  • Body Mass Index

    Body Mass IndexLearn more

    This tool considers your height and weight to assess your weight status.

  • Can we help answer your questions?

    Wellmont Nurse Connection is your resource for valuable health information any time, 24 hours a day, seven days a week. Speak to a Nurse any time, day or night, at (423) 723-6877 or toll-free at 1-877-230-NURSE.