Vesicoureteral reflux (VUR) is the retrograde passage of urine from the bladder into the upper urinary tract. Management of VUR has been based upon the premise that VUR predisposes patients to acute pyelonephritis by transporting bacteria from the bladder to the kidney. Pyelonephritis itself is a morbid event that requires acute medical care and possible hospitalization in young infants. In addition, the resulting infection may lead to loss of renal parenchyma (renal scarring). However, there are inconclusive data comparing the effectiveness of an interventional versus an observational approach in improving long-term renal outcome As a result, there is controversy regarding the optimal management of patients with VUR.
The management of VUR will be reviewed here. The manifestations and diagnosis of VUR is discussed elsewhere in the program. (See "Presentation, diagnosis, and clinical course of primary vesicoureteral reflux".)
The use of therapeutic interventions in the management of vesicoureteral reflux (VUR) is based upon the following :
●Identification of children with VUR (see "Presentation, diagnosis, and clinical course of primary vesicoureteral reflux")
●Prevention of recurrent urinary tract infections (UTI)