Bladder reflux: Vesicoureteral reflux

Our UW Health Kids specialists offer complete diagnosis and treatment of bladder reflux. We are experts at lessening the stress that kids and their parents feel when they come to the hospital.
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Overview

Vesicoureteral reflux

Vesicoureteral reflux is also known as bladder reflux. It occurs when urine flows backward from the bladder to the kidney. About 1 percent of children develop this condition, and most of them are girls. Bladder reflux isn’t always serious, but it can be. It can, in some cases, lead to infections and scarring of the kidney which may interfere with the growth of your child’s kidneys. It can also cause problems such as high blood pressure and lack of urine control. 

Symptoms and diagnosis

Recognizing symptoms, making a diagnosis

Children might have bladder reflux without having symptoms. If they do have symptoms, doctors will likely advise testing. They could suggest testing siblings of a child with the condition since they have an increased chance of having it.

Symptoms 

The most common symptom of bladder reflux is frequent urinary tract infections (UTIs). UTIs can cause: 

  • Burning or discomfort while urinating

  • Fever 

  • Foul smelling urine that may appear cloudy 

  • Frequent urination 

  • Strong sudden urges to urinate 

Other symptoms can include trouble controlling urine, bedwetting and bowel problems, such as constipation.

Diagnosis

We can use several tests to diagnose bladder reflux:

Studying urine in a lab can help doctors learn if there might be an infection. Urine cultures are done to find bacteria and confirm a UTI.

This is the main test for bladder reflux. It involves placing a small tube called a catheter into your child’s urethra. The urethra is the duct that carries urine out of the body from the bladder. We fill the bladder with a special dye. We take X-rays while the dye is filling and while your child urinates. 

This uses sound waves to create pictures of your child’s bladder and kidneys. The test can show how well the kidneys are growing. It also shows whether the ducts that carry urine from the kidneys to the bladder (the ureters) are wider than normal.

Treatments and research

Treatment tailored to your child’s needs

We grade the severity of bladder reflux on a scale of 1 to 5. Five is the most severe. The grade and your child’s age and symptoms guide decisions about treatment. 

We use antibiotics to treat UTIs. Sometimes we prescribe the drugs for daily use to prevent infections. This lessens the risk for kidney scarring. We might continue to use these drugs until your child outgrows their condition. This often happens in children with lower-grade reflux.

Bulking agents 

If your child has low- to mid-grade bladder reflux, use of a special type of bulking agent may be an option. This involves injecting a gel-like material through the urethra, the tube that carries urine out of the body. We deliver the gel to the area near the opening of the ureter, the duct that carries urine from the kidneys to the bladder. It creates a valve-like mechanism to prevent urine from flowing backward. It is a minimally invasive treatment.

Surgery 

Surgery could be an option if: 

  • Your child isn’t taking antibiotics like they should 

  • Preventive antibiotics aren’t helping 

  • The reflux is getting worse or failing to improve as your child ages

  • Your child’s kidneys aren’t working well or growing like they should 

  • There are abnormalities in your child’s bladder or ureter

Surgical treatment is known as ureteral reimplantation. Surgeons access your child’s bladder by making a small incision in the abdomen. Then they reposition the ducts that carry urine from the kidney to the bladder by tunneling them under the bladder wall. This creates what is essentially a one-way valve. The valve keeps urine from moving back to the kidney.

Meet our team

Child-driven care that delivers

At UW Health, we have a team of urologists who focus on treating children. They work with all our caregivers to improve your child’s health so they can have a bright, healthy future. 

Pediatric urologists

Patient and support services

We put your mind at ease

It’s normal for a child facing surgery to be nervous. Our surgery guide helps you and your child learn what to expect so everyone can feel more at ease.

Locations

Care close to home

  • American Family Children's Hospital - Pediatric Urology
    • 1675 Highland Ave. / Madison, WI
    • (608) 263-6420
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  • East Clinic - Pediatric Urology
    • 5249 E. Terrace Dr. / Madison, WI
    • (608) 263-6420
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  • Aurora Children's Health (Green Bay) - Pediatric Urology
    • 1160 Kepler Drive / Green Bay, WI
    • (920) 288-5500
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  • Aurora Children's Health (Oshkosh) - Pediatric Urology
    • 855 N. Westhaven Drive / Oshkosh, WI
    • (920) 303-8700
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  • Swedish American Women and Children's Hospital - Pediatric Urology
    • 1350 Charles Street / Rockford, IL
    • (779) 696-0600
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