Vesicoureteral Reflux
Treatment

Vesicoureteral reflux, or VUR, is treated either with medication or surgery, depending on the severity of the reflux, the child's age, the number and severity of urinary tract infections and the amount of kidney damage seen on X-ray studies.

Treatment always includes a low daily dose of antibiotics. These antibiotics are very specific for the urinary tract and have very few side effects. The goal is to prevent kidney infections until the reflux goes away or is corrected. The type of antibiotic we use will depend on your child's age and allergies.

Medical Therapy

Because many cases of reflux resolve on their own as the child grows, medical therapy may be all that's needed. Medical therapy entails using antibiotics to prevent infection until the condition resolves, and monitoring your child to make sure it does resolve.

Children receiving medical therapy will take a small dose of antibiotics every day. An ultrasound and cystogram will be done annually to assess the kidneys and see if the reflux has resolved. If the reflux persists for several years without improvement, surgery may be considered. If your child continues to have fever-causing urinary tract infections despite taking antibiotics, then surgery should be considered. Again, the goal is to prevent scarring or damage from a kidney infection.

Surgical Therapy

Surgery would be performed if your child has more severe reflux, fever-causing urinary tract infections despite being on antibiotics, and signs of kidney damage due to repeated infections. Surgery may also be discussed when, after giving time for the condition to go away as the child grows, repeated voiding cystourethrograms show that the reflux doesn't appear to be improving.

In the surgical procedure, the refluxing ureter is repositioned or re-implanted in the bladder wall. The end of the ureter is surrounded by bladder muscle in this new position in the bladder, which prevents urine from "backing up" or refluxing toward the bladder.

Your child will be in the hospital for three to four days. After the surgery, your child will still need to take antibiotics daily until the bladder and ureter are healed. An ultrasound will be performed about a month after surgery and, depending on the case, a voiding cystourethrogram may be performed six months following surgery.

Reviewed by health care specialists at UCSF Benioff Children's Hospital.

Related Information

UCSF Clinics & Centers

Urology

Vesicoureteral Reflux Center
1825 Fourth St., Fifth Floor, 5B
San Francisco, CA 94158
Phone: (415) 353-2200
Fax: (415) 353-2480
Appointment information