Vesicoureteral Reflux (VUR)

Healthy kidneys filter waste from the blood, producing urine which normally flows only one direction: down the ureters and into the bladder. When something is wrong with the connection between the ureter and the bladder, the urine may flow back up (reflux) from the bladder to the ureters and at times to the kidneys.

If you have had vesicoureteral reflux as a child, there is a chance that your children will have the condition. In addition, if one of your children has it, his or her brothers and sisters may also have the condition, too.

Infrequent or incomplete urination, as well as constipation, are also associated with vesicoureteral reflux in children. Frequent urinary tract infections (UTIs) may indicate the presence of vesicoureteral reflux.

 
How is Vesicoureteral Reflux In Children Diagnosed and Treated?

Your Nemours pediatric urologist may order a test called a voiding cystourethrogram (VCUG) that uses X-rays and a special dye to show how your child’s bladder is working. This test can help determine if your child has vesicoureteral reflux.

Vesicoureteral reflux in children is graded on a scale from I (mild) to V (severe). Many times, milder grades of vesicoureteral reflux will go away on their own as your child grows and develops.However, UTIs in the presence of vesicoureteral reflux can cause kidney infections, which can lead to scarring and sometimes result in kidney damage.

Depending on the severity of the vesicoureteral reflux in your child, your Nemours urologist may discuss several treatment options, including antibiotics to prevent infections, surgery to repair the ureters, or endoscopic treatment in which a small telescope is inserted through the bladder and a gel is placed at the point where the ureter meets the bladder.

Urine Test: Dipstick

What It Is

A urine dipstick test is often done as part of an overall urinalysis, but it can also be done on its own, depending on the doctor's concerns. Once a urine sample is collected, a nurse or technician will place a specially treated chemical strip (dipstick) into your child's urine. Patches on the dipstick will change color to indicate the presence of such things as white blood cells, protein, or glucose.

Why It's Done

The results of a urine dipstick test may point to a diagnosis of urinary tract infection (UTI), kidney disease, diabetes, or a urinary tract injury. If test results are abnormal, other tests will be needed before a definite diagnosis can be made.

Preparation

No preparation other than cleansing the area around the urinary opening is required for the urine dipstick test.

The Procedure

Your child will be asked to urinate into a clean sample cup in the doctor's office. If your child isn't potty trained and can't urinate into a cup, a catheter (a narrow, soft tube) may need to be inserted into the bladder to obtain the urine specimen.

The skin surrounding the urinary opening has to be cleaned and rinsed just before the urine is collected. In this "clean-catch" method, you or your child cleans the skin around the urinary opening with a special towelette. The child then urinates, stops momentarily, and then urinates again into the collection container. Catching the urine in "midstream" is the goal. Be sure to wash your hands and your child's hands after this process.

Once collected, the technician or nurse will then place the dipstick into the urine sample. Collecting the specimen should only take a few minutes.

What to Expect

Because the test involves normal urination; there shouldn't be any discomfort as long as your child can provide a urine specimen. It's important to keep the area around the urinary opening clean before the test and to catch the urine sample midstream.

Getting the Results

The results of the urine dipstick test will be available right away. If abnormalities are found, further urine tests will be needed. Talk to your child's doctor about the meaning of the specific test results.

Risks

No risks are associated with taking a urine dipstick test. If a catheterized specimen is required it may cause temporary discomfort and you can discuss any questions you have about this procedure with your healthcare provider.

Helping Your Child

The urine dipstick test is painless. Explaining how the test will be conducted, and why it's being done, can help ease your child's fear. Make sure your child understands that the urinary opening must be clean and the urine must be collected midstream.

If You Have Questions

If you have questions about the urine dipstick test, speak with your doctor.

Reviewed by: Yamini Durani, MD
Date reviewed: February 2012