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(VUR; Reflux Nephropathy; Chronic Atrophic Pyelonephritis; Vesico-Ureteric Reflux; Ureteral Reflux)
Pronounced: VEH-sih-co-ya-REET-uh-rul REE-flux
by Sonja Lyons
Vesicoureteral reflux (VUR) is the backward flow of urine. The urine flows from the bladder back into the ureters or kidney.
Types of VUR:
Urine normally flows from the kidneys. It passes through tubes called ureters and into the bladder. Each ureter connects to the bladder in a way that prevents the backflow of urine. The connection is similar to a one-way valve. When the valve does not work properly, or if the ureters do not extend far enough into the bladder, urine may flow back up the ureter and into the kidney.
Most VUR results from residual, undected childhood disease, but may have other causes. Some examples include:
Risk Factors TOP
VUR is more common in women and in those who are Caucasian. Other factors that may increase your chances of VUR include:
Generally, VUR has no symptoms and can remain undetected into adulthood. In some, it is found after a urinary tract or kidney infection is diagnosed and evaluated. Flank pain may be present during the time the bladder is filling with urine.
Complications of undetected or untreated VUR include:
You will be asked about your symptoms and medical history. A physical exam will be done. Your doctor may suspect VUR based on your history. Many times VUR is found incidentally during testing for another problem, such as high blood pressure, kidney stones, neurogenic bladder, other urinary problems, or abdominal pain.
If your doctor suspects VUR, a voiding cystourethrogram (VCUG) is usually done. VCUG is an imaging test that evaluates structures during urination. Other tests may include:
VUR in adults does not usually resolve over time. The goal for treatment of VUR is to reduce or stop the back up, and prevent additional and permanent damage. Treatment depends on the severity of VUR and may include one or more of the following options:
Medications can be used to:
Surgery may be done for more severe VUR or in cases when other treatment methods fail. Procedures include:
To help reduce your chances of VUR:
National Kidney Foundation
Urology Care Foundation
The Kidney Foundation of Canada
Berquist TH, Hattery RR, Hartman GW, Kelalis PP. Vesicoureteral reflux in adults. Am J Roentgenol Radium Ther Nucl Med. 1975;125(2):314-321. Available at:
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Freidman AA, Hanna MK. Vesicoureteral reflux and the adult. In: Wood HM, Woods D, ed. Current Clinical Urology. Springer International Publishing;2015:173-205.
Mattoo TK. Vesicoureteral reflux and reflux nephropathy. Adv Chronic Kidney Dis. 2011;18(5):348-54.
Rollino C, D'Urso L, Beltrame G, Ferro M. Vesicoureteral reflux in adults. G Ital Nefrol. 2011;28(6):599-611.
Last reviewed February 2015 by Michael Woods, MD, FAAP
Last Updated: 2/23/2017
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