VUR - Vesico Ureteric Reflux

Vesico ureteric reflux or VUR happens when there is a problem with the valve that is supposed to prevent urine from flowing back out of the bladder. Urine can pass back up through the ureter towards the kidneys. If this reflux of urine causes problems then surgery may be needed to help the valve work properly. 

What is VUR?

Vesico ureteric reflux is a condition that occurs when urine flows backwards through the urinary tract and into the kidneys. Urine is usually produced in the kidneys and then carried down the ureters into the bladder. The bladder should store the urine until it leaves the body when your child urinates. The vesico-ureteric valve sits in between the ureter and the bladder. It usually stops urine from flowing backwards along the ureter. VUR occurs when there is a problem that stops this valve from working properly. Urine travels backwards out of the bladder, along the ureter, and into the kidney.

Signs of Vesico Ureteric Reflux

Vesico ureteric reflux is sometimes diagnosed during a pregnancy scan. The baby's ureter may appear enlarged or change in shape and size. The diagnosis can then be confirmed after the baby is born.

VUR can also be diagnosed in older children. It is usually spotted after a urinary tract infection (UTI). Signs of a UTI in children can include:

• fever
• needing to urinate more often
• having to urinate urgently
• bad smelling urine
• vomiting or loss of appetite
• abdominal pain

If your child often has UTIs then your doctor may recommend tests to check for an underlying cause, such as VUR.

Causes of VUR

The causes of VUR aren't fully understood, but it does seem to run in some families. The condition is also more common in girls than in boys, although it can affect anyone. If an older child in the family has been diagnosed with VUR then your doctor might recommend screening any younger siblings to check for the same condition.

Treatments for VUR

VUR can often be managed by ensuring that your child empties their bladder completely and using antibiotics to treat any urinary infections. Better bladder function can prevent urine from building up and making its way back up the ureter. However, if your child still suffers from frequent urinary infections or there is a risk of damage to the kidneys, the doctor may recommend surgery.

Two different types of surgery can be used to treat VUR. The traditional method was to detach the ureters from the bladder and then reattach them in a new position. The ureters would be reattached in such a way that the function of the valve improved. However, in many cases it is now possible to treat VUR with a less invasive procedure. A laparoscopic or keyhole procedure can be performed to inject some material into the vesico-ureteric valve in order to help it function correctly.

If your child has VUR then it is important to get advice from a specialist. A paediatric urologist can monitor their condition and advise you on whether surgery would be a good idea for your child.