Retrograde urine flow from bladder toward kidney(s)
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
Kim D et al: Contrast-enhanced voiding urosonography for the diagnosis of vesicoureteral reflux and intrarenal reflux: a comparison of diagnostic performance with fluoroscopic voiding cystourethrography. Ultrasonography. 40(4):530-7, 2021
Ntoulia A et al: Contrast-enhanced voiding urosonography, part 1: vesicoureteral reflux evaluation. Pediatr Radiol. ePub, 2021
Janssen KM et al: Standardized protocol for voiding cystourethrogram: are recommendations being followed? J Pediatr Urol.17(1):66.e1-6, 2020
Ji D et al: Accuracy of subjective vesicoureteral reflux timing assessment: supporting new voiding cystourethrogram guidelines. Pediatr Radiol. 50(7):953-7, 2020
Walawender L et al: Diagnosis and imaging of neonatal UTIs. Pediatr Neonatol. 61(2):195-200, 2020
Arlen AM et al: New trends in voiding cystourethrography and vesicoureteral reflux: who, when and how? Int J Urol. 26(4):440-5, 2019
Capone V et al: Voiding cystourethrography and 99MTC-MAG3 renal scintigraphy in pediatric vesicoureteral reflux: what is the role of indirect cystography? J Pediatr Urol. 15(5):514.e1-6, 2019
Garin EH: Primary vesicoureteral reflux; what have we learnt from the recently published randomized, controlled trials? Pediatr Nephrol. 34(9):1513-9, 2019
Kosmeri C et al: An update on renal scarring after urinary tract infection in children: what are the risk factors? J Pediatr Urol. 15(6):598-603, 2019
Rensing AJ et al: Radiographic abnormalities, bladder interventions, and bladder surgery in the first decade of life in children with spina bifida. Pediatr Nephrol. 34(7):1277-82, 2019
Schneider KO et al: Intrarenal reflux, an overlooked entity - retrospective analysis of 1,166 voiding cysturethrographies in children. Pediatr Radiol. 49(5):617-25, 2019
Velasquez M et al: The learning curve of contrast-enhanced 'microbubble' voiding urosonography-validation study. J Pediatr Urol. 15(4):385.e1-6, 2019
Kim HK et al: Feasibility of superb microvascular imaging to detect high-grade vesicoureteral reflux in children with urinary tract infection. Eur Radiol. 28(1):66-73, 2018
Ntoulia A et al: Contrast-enhanced voiding urosonography (ceVUS) with the intravesical administration of the ultrasound contrast agent Optison™ for vesicoureteral reflux detection in children: a prospective clinical trial. Pediatr Radiol. 48(2):216-26, 2018
Wang ZT et al: A reanalysis of the RIVUR trial using a risk classification system. J Urol. 199(6):1608-1614, 2018
Duran C et al: Contrast-enhanced voiding urosonography for vesicoureteral reflux diagnosis in children. Radiographics. 37(6):1854-69, 2017
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
Weitz M et al: To screen or not to screen for vesicoureteral reflux in children with ureteropelvic junction obstruction: a systematic review. Eur J Pediatr. 176(1):1-9, 2016
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
Mattoo TK et al: The RIVUR trial: a factual interpretation of our data. Pediatr Nephrol. 30(5):707-12, 2015
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
Stein R et al: Urinary tract infections in children: EAU/ESPU guidelines. Eur Urol. 67(3):546-58, 2015
Botta S et al: To V(CUG) or not to V(CUG) in infants with prenatal hydronephrosis? J Urol. 192(3):640-1, 2014
Downs SM: UTI and watchful waiting: the courage to do nothing. Pediatrics. 133(3):535-6, 2014
Hoberman A et al: Antimicrobial prophylaxis for children with vesicoureteral reflux. N Engl J Med. 371(11):1072-3, 2014
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
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
RIVUR Trial Investigators et al: Antimicrobial prophylaxis for children with vesicoureteral reflux. N Engl J Med. 370(25):2367-76, 2014
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
Carpenter MA et al: The RIVUR trial: profile and baseline clinical associations of children with vesicoureteral reflux. Pediatrics. 132(1):e34-45, 2013
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
Tekgül S et al: EAU guidelines on vesicoureteral reflux in children. Eur Urol. 62(3):534-42, 2012
Novljan G et al: Ultrasound detection of vesicoureteral reflux in children. J Urol. 184(1):319-24, 2010
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
Taskinen S et al: Post-pyelonephritic renal scars are not associated with vesicoureteral reflux in children. J Urol. 173(4):1345-8, 2005
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
Pathology
Clinical Issues
TERMINOLOGY
Abbreviations
Vesicoureteral reflux (VUR)
Synonyms
Vesicoureteric reflux
Definitions
Retrograde urine flow from bladder toward kidney(s)
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
Kim D et al: Contrast-enhanced voiding urosonography for the diagnosis of vesicoureteral reflux and intrarenal reflux: a comparison of diagnostic performance with fluoroscopic voiding cystourethrography. Ultrasonography. 40(4):530-7, 2021
Ntoulia A et al: Contrast-enhanced voiding urosonography, part 1: vesicoureteral reflux evaluation. Pediatr Radiol. ePub, 2021
Janssen KM et al: Standardized protocol for voiding cystourethrogram: are recommendations being followed? J Pediatr Urol.17(1):66.e1-6, 2020
Ji D et al: Accuracy of subjective vesicoureteral reflux timing assessment: supporting new voiding cystourethrogram guidelines. Pediatr Radiol. 50(7):953-7, 2020
Walawender L et al: Diagnosis and imaging of neonatal UTIs. Pediatr Neonatol. 61(2):195-200, 2020
Arlen AM et al: New trends in voiding cystourethrography and vesicoureteral reflux: who, when and how? Int J Urol. 26(4):440-5, 2019
Capone V et al: Voiding cystourethrography and 99MTC-MAG3 renal scintigraphy in pediatric vesicoureteral reflux: what is the role of indirect cystography? J Pediatr Urol. 15(5):514.e1-6, 2019
Garin EH: Primary vesicoureteral reflux; what have we learnt from the recently published randomized, controlled trials? Pediatr Nephrol. 34(9):1513-9, 2019
Kosmeri C et al: An update on renal scarring after urinary tract infection in children: what are the risk factors? J Pediatr Urol. 15(6):598-603, 2019
Rensing AJ et al: Radiographic abnormalities, bladder interventions, and bladder surgery in the first decade of life in children with spina bifida. Pediatr Nephrol. 34(7):1277-82, 2019
Schneider KO et al: Intrarenal reflux, an overlooked entity - retrospective analysis of 1,166 voiding cysturethrographies in children. Pediatr Radiol. 49(5):617-25, 2019
Velasquez M et al: The learning curve of contrast-enhanced 'microbubble' voiding urosonography-validation study. J Pediatr Urol. 15(4):385.e1-6, 2019
Kim HK et al: Feasibility of superb microvascular imaging to detect high-grade vesicoureteral reflux in children with urinary tract infection. Eur Radiol. 28(1):66-73, 2018
Ntoulia A et al: Contrast-enhanced voiding urosonography (ceVUS) with the intravesical administration of the ultrasound contrast agent Optison™ for vesicoureteral reflux detection in children: a prospective clinical trial. Pediatr Radiol. 48(2):216-26, 2018
Wang ZT et al: A reanalysis of the RIVUR trial using a risk classification system. J Urol. 199(6):1608-1614, 2018
Duran C et al: Contrast-enhanced voiding urosonography for vesicoureteral reflux diagnosis in children. Radiographics. 37(6):1854-69, 2017
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
Weitz M et al: To screen or not to screen for vesicoureteral reflux in children with ureteropelvic junction obstruction: a systematic review. Eur J Pediatr. 176(1):1-9, 2016
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
Mattoo TK et al: The RIVUR trial: a factual interpretation of our data. Pediatr Nephrol. 30(5):707-12, 2015
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
Stein R et al: Urinary tract infections in children: EAU/ESPU guidelines. Eur Urol. 67(3):546-58, 2015
Botta S et al: To V(CUG) or not to V(CUG) in infants with prenatal hydronephrosis? J Urol. 192(3):640-1, 2014
Downs SM: UTI and watchful waiting: the courage to do nothing. Pediatrics. 133(3):535-6, 2014
Hoberman A et al: Antimicrobial prophylaxis for children with vesicoureteral reflux. N Engl J Med. 371(11):1072-3, 2014
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
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
RIVUR Trial Investigators et al: Antimicrobial prophylaxis for children with vesicoureteral reflux. N Engl J Med. 370(25):2367-76, 2014
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
Carpenter MA et al: The RIVUR trial: profile and baseline clinical associations of children with vesicoureteral reflux. Pediatrics. 132(1):e34-45, 2013
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
Tekgül S et al: EAU guidelines on vesicoureteral reflux in children. Eur Urol. 62(3):534-42, 2012
Novljan G et al: Ultrasound detection of vesicoureteral reflux in children. J Urol. 184(1):319-24, 2010
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
Taskinen S et al: Post-pyelonephritic renal scars are not associated with vesicoureteral reflux in children. J Urol. 173(4):1345-8, 2005
Fernbach SK et al: Pediatric voiding cystourethrography: a pictorial guide. Radiographics. 20(1):155-68; discussion 168-71, 2000
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