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Pediatrics
Diagnosis
Genitourinary
Congenital Urinary Tract Abnormalities
Vesicoureteral Reflux
Vesicoureteral Reflux
Sara M. O'Hara, MD, FAAP
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KEY FACTS

  • Terminology

    • Imaging

      • Clinical Issues

        TERMINOLOGY

        • Abbreviations

          • Vesicoureteral reflux (VUR)

        • Synonyms

          • Vesicoureteric reflux

        • Definitions

          • Retrograde flow of urine from bladder toward 1 or both kidneys

        IMAGING

        • General Features

          • Fluoroscopic Findings

            • Ultrasonographic Findings

              • Nuclear Medicine Findings

                • Imaging Recommendations

                  DIFFERENTIAL DIAGNOSIS

                    PATHOLOGY

                    • General Features

                      • Staging, Grading, & Classification

                        • Gross Pathologic & Surgical Features

                          CLINICAL ISSUES

                          • Presentation

                            • Demographics

                              • Natural History & Prognosis

                                • Treatment

                                  Selected References

                                  1. Mattoo TK et al: Renal scarring in the randomized intervention for children with vesicoureteral reflux (RIVUR) Trial. Clin J Am Soc Nephrol. 11(1):54-61, 2016
                                  2. Bush NC et al: Renal damage detected by DMSA, despite normal renal ultrasound, in children with febrile UTI. J Pediatr Urol. 11(3):126.e1-7, 2015
                                  3. Mattoo TK et al: The RIVUR trial: a factual interpretation of our data. Pediatr Nephrol. 30(5):707-12, 2015
                                  4. Narchi H et al: Renal tract abnormalities missed in a historical cohort of young children with UTI if the NICE and AAP imaging guidelines were applied. J Pediatr Urol. 11(5):252.e1-7, 2015
                                  5. Stein R et al: Urinary tract infections in children: EAU/ESPU guidelines. Eur Urol. 67(3):546-58, 2015
                                  6. Botta S et al: To V(CUG) or not to V(CUG) in infants with prenatal hydronephrosis? J Urol. 192(3):640-1, 2014
                                  7. Downs SM: UTI and watchful waiting: the courage to do nothing. Pediatrics. 133(3):535-6, 2014
                                  8. Hoberman A et al: Antimicrobial prophylaxis for children with vesicoureteral reflux. N Engl J Med. 371(11):1072-3, 2014
                                  9. Kern AJ et al: Best of the 2014 AUA annual meeting: highlights from the 2014 american urological association annual meeting, May 16-21, 2014, Orlando, FL. Rev Urol. 16(3):139-44, 2014
                                  10. Ristola MT et al: NICE guidelines cannot be recommended for imaging studies in children younger than 3 years with urinary tract infection. Eur J Pediatr Surg. 25(5):414-20, 2014
                                  11. RIVUR Trial Investigators et al: Antimicrobial prophylaxis for children with vesicoureteral reflux. N Engl J Med. 370(25):2367-76, 2014
                                  12. Suson KD et al: Evaluation of children with urinary tract infection--impact of the 2011 AAP guidelines on the diagnosis of vesicoureteral reflux using a historical series. J Pediatr Urol. 10(1):182-5, 2014
                                  13. Carpenter MA et al: The RIVUR trial: profile and baseline clinical associations of children with vesicoureteral reflux. Pediatrics. 132(1):e34-45, 2013
                                  14. La Scola C et al: Different guidelines for imaging after first UTI in febrile infants: yield, cost, and radiation. Pediatrics. 131(3):e665-71, 2013
                                  15. Tekgül S et al: EAU guidelines on vesicoureteral reflux in children. Eur Urol. 62(3):534-42, 2012
                                  16. Novljan G et al: Ultrasound detection of vesicoureteral reflux in children. J Urol. 184(1):319-24, 2010
                                  17. Shaikh N et al: Risk of renal scarring in children with a first urinary tract infection: a systematic review. Pediatrics. 126(6):1084-91, 2010
                                  18. Taskinen S et al: Post-pyelonephritic renal scars are not associated with vesicoureteral reflux in children. J Urol. 173(4):1345-8, 2005
                                  19. Fernbach SK et al: Pediatric voiding cystourethrography: a pictorial guide. Radiographics. 20(1):155-68; discussion 168-71, 2000
                                  Related Anatomy
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                                  Related Differential Diagnoses
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                                  References
                                  Tables

                                  Tables

                                  KEY FACTS

                                  • Terminology

                                    • Imaging

                                      • Clinical Issues

                                        TERMINOLOGY

                                        • Abbreviations

                                          • Vesicoureteral reflux (VUR)

                                        • Synonyms

                                          • Vesicoureteric reflux

                                        • Definitions

                                          • Retrograde flow of urine from bladder toward 1 or both kidneys

                                        IMAGING

                                        • General Features

                                          • Fluoroscopic Findings

                                            • Ultrasonographic Findings

                                              • Nuclear Medicine Findings

                                                • Imaging Recommendations

                                                  DIFFERENTIAL DIAGNOSIS

                                                    PATHOLOGY

                                                    • General Features

                                                      • Staging, Grading, & Classification

                                                        • Gross Pathologic & Surgical Features

                                                          CLINICAL ISSUES

                                                          • Presentation

                                                            • Demographics

                                                              • Natural History & Prognosis

                                                                • Treatment

                                                                  Selected References

                                                                  1. Mattoo TK et al: Renal scarring in the randomized intervention for children with vesicoureteral reflux (RIVUR) Trial. Clin J Am Soc Nephrol. 11(1):54-61, 2016
                                                                  2. Bush NC et al: Renal damage detected by DMSA, despite normal renal ultrasound, in children with febrile UTI. J Pediatr Urol. 11(3):126.e1-7, 2015
                                                                  3. Mattoo TK et al: The RIVUR trial: a factual interpretation of our data. Pediatr Nephrol. 30(5):707-12, 2015
                                                                  4. Narchi H et al: Renal tract abnormalities missed in a historical cohort of young children with UTI if the NICE and AAP imaging guidelines were applied. J Pediatr Urol. 11(5):252.e1-7, 2015
                                                                  5. Stein R et al: Urinary tract infections in children: EAU/ESPU guidelines. Eur Urol. 67(3):546-58, 2015
                                                                  6. Botta S et al: To V(CUG) or not to V(CUG) in infants with prenatal hydronephrosis? J Urol. 192(3):640-1, 2014
                                                                  7. Downs SM: UTI and watchful waiting: the courage to do nothing. Pediatrics. 133(3):535-6, 2014
                                                                  8. Hoberman A et al: Antimicrobial prophylaxis for children with vesicoureteral reflux. N Engl J Med. 371(11):1072-3, 2014
                                                                  9. Kern AJ et al: Best of the 2014 AUA annual meeting: highlights from the 2014 american urological association annual meeting, May 16-21, 2014, Orlando, FL. Rev Urol. 16(3):139-44, 2014
                                                                  10. Ristola MT et al: NICE guidelines cannot be recommended for imaging studies in children younger than 3 years with urinary tract infection. Eur J Pediatr Surg. 25(5):414-20, 2014
                                                                  11. RIVUR Trial Investigators et al: Antimicrobial prophylaxis for children with vesicoureteral reflux. N Engl J Med. 370(25):2367-76, 2014
                                                                  12. Suson KD et al: Evaluation of children with urinary tract infection--impact of the 2011 AAP guidelines on the diagnosis of vesicoureteral reflux using a historical series. J Pediatr Urol. 10(1):182-5, 2014
                                                                  13. Carpenter MA et al: The RIVUR trial: profile and baseline clinical associations of children with vesicoureteral reflux. Pediatrics. 132(1):e34-45, 2013
                                                                  14. La Scola C et al: Different guidelines for imaging after first UTI in febrile infants: yield, cost, and radiation. Pediatrics. 131(3):e665-71, 2013
                                                                  15. Tekgül S et al: EAU guidelines on vesicoureteral reflux in children. Eur Urol. 62(3):534-42, 2012
                                                                  16. Novljan G et al: Ultrasound detection of vesicoureteral reflux in children. J Urol. 184(1):319-24, 2010
                                                                  17. Shaikh N et al: Risk of renal scarring in children with a first urinary tract infection: a systematic review. Pediatrics. 126(6):1084-91, 2010
                                                                  18. Taskinen S et al: Post-pyelonephritic renal scars are not associated with vesicoureteral reflux in children. J Urol. 173(4):1345-8, 2005
                                                                  19. Fernbach SK et al: Pediatric voiding cystourethrography: a pictorial guide. Radiographics. 20(1):155-68; discussion 168-71, 2000