What is vesicoureteral reflux or urinary reflux in children?

Vesicoureteral reflux (VUR) is a medical disorder of the urinary system. The urinary system is composed of the kidneys, ureters, bladder, and urethra that together excrete waste products from the body via urine. Thin tubes called the ureters to carry urine from the kidneys down to the bladder. The urine is stored in the bladder before it exits the body through another tube called the urethra during urination.

In the normal state, the flow of urine is unidirectional, from the kidneys to the urethra, through the ureters. However, in VUR the direction of this flow gets reversed and the urine flows back into the ureters and kidneys from the urethra.

Vesicoureteral reflux is diagnosed more often in infants and children up to 2 years of age. Girls have a much higher risk of having this condition than boys.

The risk of developing recurrent kidney infections increases in children with VUR. Over some time, recurrent infections can lead to damage and scarring of the kidneys.

Children with VUR are managed by pediatric nephrologists who treat children with problems of kidney or pediatric urologists who perform surgeries of the genital and urinary tract of children.

What are the causes of vesicoureteral reflux?

Vesicoureteral reflux can take two forms namely, primary and secondary:

Primary vesicoureteral reflux: A defect in the valve that prevents the backflow of urine from the bladder into the ureters may be present since birth in the primary vesicoureteral reflux. It is the more common type.

With the lengthening and straightening of the ureters, as the child grows, the function of the valve may improve. Consequently, the reflux gets corrected.

The exact cause of the defect remains unknown. However, it is suspected to be genetic, as it tends to run in families. This defect is more common in boys.

Secondary vesicoureteral reflux: A blockage or defect of the bladder muscle or damage to the nerves that control normal bladder emptying, may lead to failure of the bladder to empty properly.