Page 2 - Vesicoureteric Reflux

Vesicoureteric reflux
Follow-up
Your doctor may recommend regular cystograms,
usually once every 12-18 months, and periodic
ultrasounds until the VUR has resolved or your child is
out of the period of risk.
Treatment of VUR
In some cases, VUR is best corrected with surgery.
Surgery is often recommended if a child develops a
severe urinary infection while on preventive antibiotics
or if preventive antibiotics cannot be taken.
Worsening VUR or new kidney scarring demonstrated
on follow-up imaging studies may indicate the
need for surgery, as may persistent VUR despite an
adequate period of observation.
Two surgical approaches are available to correct
VUR. The STING procedure involves the injection of
an implant under the connection of the ureter to
the bladder to strengthen the flap valve. This is done
under general anaesthetic (your child is asleep),
through a narrow tube (cystoscope) passed through
the urethra. No incision is required and your child
should be able to return home on the day of surgery.
The STING procedure has a high cure rate, but some
children require more than one injection.
Ureteric reimplantation is recommended for some
children with VUR. A flap valve is created by tunneling
the affected ureter through the bladder wall. A
general anaesthetic is required and an incision
is made in the lower abdomen. Your child will be
admitted to hospital on the day of surgery and stay
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The information in the publication is not intended to convey medical advice or to substitute for direct consultation with a qualified medical
practitioner. The Canadian Urological Association disclaims all liability and legal responsibility howsoever caused, including negligence, for the
information contained in or referenced by this brochure.
© 2014. Canadian Urological Association. All rights reserved.
for a few days. A bladder or ureteric drainage tube
may be used for a few days after surgery to drain
urine. Your child should be able to resume normal
activities in a few weeks.
A few months after either surgical procedure, a VCUG
or nuclear cystogram may be done to confirm that
VUR has resolved.
Other considerations
Women who have had VUR as girls often have an
increased risk of urinary infections with the onset of
sexual activity and pregnancy, even if the VUR has
been successfully corrected. Kidney scarring resulting
from childhood infections may predispose to high
blood pressure in adults. The blood pressure should
be monitored regularly in any adult who has had VUR
with kidney scarring.
VUR may run in families. Up to two thirds of the
children of refluxing parents are born with VUR. About
one third of brothers and sisters of children with VUR
will also have the problem even if they have never
had a UTI. Your doctor can discuss the pros and cons
of screening imaging studies for any children at risk of
VUR.
VUR is a common problem in children with urinary
infections. Most often, it will resolve in time without
treatment or serious consequence as long as infection
is prevented. Surgery can successfully cure VUR in
those children who need treatment.
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