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Home >> Pediatric Urology >> Vesicoureteral Reflux >> Diagnosis
Vesicoureteral Reflux - Diagnosis
Overview | Diagnosis | Treatment | FAQ
VUR is most often uncovered because of urinary tract infection. VUR might also be uncovered during workup for unexplained fever, abdominal pain, urinary incontinence, protein in the urine (proteinuria), hypertension, or failure to thrive. Furthermore if there is a family history of VUR, or if a prenatal renal ultrasound showed hydronephrosis (dilation of the kidney collecting system) that fails to resolve, testing may be indicated. A  special test called a voiding cystourethrogram (VCUG) is done to evaluate for the presence and severity of urinary reflux. To perform a VCUG, a special solution that is visible with x-ray is instilled into the bladder through a tiny catheter that is inserted into the bladder through the urethra. During urination, the bladder, ureters, and kidneys are continuously monitored with x-rays for any sign of urinary reflux. VUR is graded on a scale of 1-5. If urine just refluxes into the ureter, it’s called grade 1 VUR. The grade of reflux increases with progressive dilation of the ureter and upper collecting system in the kidneys. For the workup of many urinary tract problems, including UTI, a renal ultrasound is performed to evaluate the size and configuration of the kidneys. If a serious renal infection has occured, a nuclear medicine study called a DMSA renal scan may be ordered to determine if there is any evidence of renal scarring.
Once a diagnosis of VUR has been made, annual surveillance with a renal ultrasound and a nuclear VCUG (a radioactive tracer is used instead of x-rays, which reduces radiation exposure) is performed until the VUR resolves or has been successfully treated.
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