There are two types of vesicoureteral reflux: primary vesicoureteral reflux and secondary vesicoureteral reflux.
Primary vesicoureteral reflux occurs when a child is born with an impaired valve where the ureter joins the bladder. This happens if the ureter did not grow long enough during the child's development in the womb. In primary vesicoureteral reflux, the valve does not close properly, so urine backs up (refluxes) from the bladder to the ureters, and eventually to the kidneys. As the child ages, this type of vesicoureteral reflux can get better or it can disappear altogether.
Secondary vesicoureteral reflux, also known as a reflux of urine to the kidneys, occurs when there is a blockage in the urinary system. This blockage may be caused by an infection in the bladder that leads to swelling of the ureter.
Infection is the most common symptom of vesicoureteral reflux. As the child gets older, other symptoms may appear, including:
In order to diagnose vesicoureteral reflux, patients will need to take a urine test. However, more than one of the following imaging tests may also be needed.
Kidney and Bladder Ultrasound
An ultrasound can examine the kidney and bladder by using sound waves. An ultrasound is able to show shadows of the kidney and bladder that may point out certain abnormalities. However, this test cannot reveal all urinary abnormalities and it cannot measure how well a kidney works.
Voiding Cystourethrogram (VCUG)
A VCUG is a test that examines the urethra and bladder while the bladder fills and empties. In a VCUG, a liquid that can be seen on x-rays is placed into the bladder through a catheter. The bladder is filled until the child urinates. This test can reveal abnormalities of the inside of the urethra and bladder and it can also determine whether the flow of urine is normal when the bladder empties.
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