Vesicoureteral Reflux


Urine flows from the kidneys to the bladder through tubes called ureters. Ureters have a one-way valve that prevents urine from backing up (called reflux) into the kidneys.

In children with a condition called vesicoureteral reflux (VUR), this process doesn’t work correctly, and urine in the bladder can flow backward, sometimes, back into the kidneys. This fluid can carry bacteria, resulting in frequent kidney infections. Over time, this can lead to kidney damage.

Types & Grades of VUR

Primary VUR

Primary VUR is usually caused by a congenital abnormality, meaning it is present at birth. It’s most often diagnosed in infancy and early childhood and may be found during prenatal ultrasound exams.

Secondary Reflux

Secondary reflux is caused by a urinary tract infection (UTI) or a problem in the urinary tract.

Grades of VUR

There also are five grades of VUR based on how severe the condition is, ranging from urine backing up only into the lower ureter (Grade 1), to urine reaching all the way into the kidney, causing a condition known as hydronephrosis and eventual kidney damage (Grade V).

Symptoms of Vesicoureteral Reflux

Children with VUR may have the following symptoms.

  • Problems with urination including:
    • Urgency (feeling the need to urinate often, even if little or no urine is produced)
    • Dribbling (releasing slight amounts of urine involuntarily)
    • Wetting pants

Many of these symptoms also may be caused by other conditions. If your child has any of these signs, make an appointment with your Mercy Kids pediatrician to find out what’s going on and how to treat it.

Treating Vesicoureteral Reflux

Our pediatric urologists specialize in diagnosing, treating and preventing urinary problems. If your child has vesicoureteral reflux, we will develop a personalized treatment plan based on the grade of their VUR, as well as their symptoms, age and overall health.

Grades 1-3 Treatment

Many children with grades 1-3 VUR don’t need treatment because the problem resolves on its own, usually by age 5. If your child has frequent infections, we may prescribe a low-dose antibiotic taken daily to prevent them. Our urologists will monitor your child’s condition and may test their urine on a regular basis. If ongoing infections become a problem, surgery may be an option.

Grades 4-5 Treatment

Children with grades 4-5 VUR may need surgery to correct the problem. Mercy Kids pediatric urologic surgeons perform a procedure to prevent the urine from backing up in the ureters, using minimally invasive techniques whenever possible.


Deflux is a specific treatment offered as a one-time injection in the bladder (while your child is sedated), which can often be used instead of more invasive surgery.

Mercy pediatric specialists treat our youngest patients with the most advanced techniques and gentle, understanding care. We’ll do our best to resolve your child’s urinary condition and get them back to being a healthy kid.

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