Vesico-ureteric Reflux

These pages describe Vesico-ureteral reflux (VUR) and why it happens. VUR is often simply known as ‘reflux.’ Diagnosis and treatments are also outlined.

What is it and what are the causes?

Reflux occurs when urine travels up the ureter from the bladder towards the kidney while the bladder is emptying.VUR is a congenital condition; about 1% of people are born with it. It is not always found soon after birth, but may be found in childhood or discovered in adults. It may never cause trouble for some people.

• It is due to an awkwardly shaped entrance to the bladder from the ureter.
• Normally the entrance works like a trapdoor that swings shuts when urine is passed, this prevents higher pressures in the bladder from affecting the kidneys. In those with VUR, the entrance stays open and reflux results.
• Continuing problems with reflux can lead to further scarring and infections.
• This disease and scarring are known as Reflux Nephropathy.
• Reflux Nephropathy is also known as Chronic Pyelonephritis.
• Reflux has been estimated to cause up to 10% of renal failure in the UK.
• Brothers and sisters of affected children have a higher chance (up to 50%) of having VUR. Children with a parent affected by VUR are also more likely to have reflux.
• Children with VUR may get worse kidney damage before 5 years of age, due to frequent kidney infections.
• Kidney damage can cause high blood pressure later on, and even kidney failure.
• In around 80% of cases, the reflux stops by the age of ten years, but any kidney scarring will remain.