Vesicoureteral reflux

Larry A Greenbaum1, Hrair-George O Mesrobian

  • 1Division of Pediatric Nephrology, Emory University School of Medicine, Children's Healthcare of Atlanta, 2015 Uppergate Drive NE, Atlanta, GA 30322, USA. Lary_Greenbaum@oz.ped.emory.edu

Insights

Vesicoureteral reflux, a common congenital anomaly in children, involves urine flowing backward into the ureter. Understanding its links to infections and kidney damage is crucial for effective management strategies.

Area of Science:

  • Pediatric Urology
  • Congenital Anomalies
  • Nephrology

Background:

  • Vesicoureteral reflux is a frequent congenital anomaly in pediatric patients.
  • It is characterized by the abnormal retrograde flow of urine from the bladder to the ureter.
  • This condition is clinically significant due to its association with urinary tract infections and renal scarring.

Purpose of the Study:

  • To review current understanding of vesicoureteral reflux pathogenesis.
  • To discuss evolving surgical techniques for managing this condition.
  • To highlight the clinical implications of reflux, infection, and renal damage.

Main Methods:

  • Literature review of recent advancements in understanding vesicoureteral reflux.
  • Analysis of new and established surgical interventions.
  • Synthesis of clinical data on associated complications.

Main Results:

  • New insights into the pathogenesis of vesicoureteral reflux have emerged.
  • Novel surgical techniques are being developed and refined.
  • The clinical management approach is adapting to these advancements.

Conclusions:

  • Vesicoureteral reflux management is evolving with new pathogenetic insights and surgical options.
  • Early detection and appropriate intervention are key to preventing renal damage.
  • Continued research is vital for optimizing pediatric urological care.

Related Concept Videos

Imaging Studies VI: Voiding Cystourethrography and Cystography01:22

Imaging Studies VI: Voiding Cystourethrography and Cystography

Voiding Cystourethrography (VCUG) and Cystography are specialized radiographic procedures used to examine the structure and function of the bladder and urethra.Voiding Cystourethrography (VCUG)A Voiding Cystourethrogram (VCUG) is a diagnostic imaging procedure that assesses the anatomy and function of the lower urinary tract. It focuses on the bladder, bladder neck, and urethra, helping detect abnormalities such as vesicoureteral reflux (VUR)—the backward or reverse flow of urine into the...
Ureters01:22

Ureters

The ureters are retroperitoneal tubes located on either side of the vertebral column. They are responsible for transporting urine from each kidney to the urinary bladder. These tubes have thick walls and are approximately 25-30 cm long. Their diameter is around 10 mm at the renal pelvis, gradually narrowing to 1 mm as the ureter obliquely enters the posterior bladder wall through the ureteric orifices. The shape of these orifices is slit-like, which helps to prevent urine backflow toward the...
Imaging Studies V: Intravenous Urography and Retrograde Pyelography01:22

Imaging Studies V: Intravenous Urography and Retrograde Pyelography

IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...
The Micturition Reflex01:26

The Micturition Reflex

Urination, or micturition involves the coordination of the bladder's detrusor muscle and two sphincters to ensure controlled bladder emptying.
The process begins with bladder filling, where the bladder wall stretches as urine accumulates. This stretching activates the urine storage reflex, mediated by the sacral spinal segments and the pontine storage center. Efferent sympathetic impulses stimulate the detrusor muscle to relax and the internal urethral sphincter to contract, facilitating urine...
Acute Pyelonephritis I: Introduction01:27

Acute Pyelonephritis I: Introduction

Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such as Proteus,...
Urinary Tract Calculi I: Introduction01:28

Urinary Tract Calculi I: Introduction

Renal calculi, or kidney stones, are solid deposits of minerals and salts formed inside the kidneys. In medical terminology, "calculus" refers to the stone itself, while "lithiasis" describes the process of stone formation. Depending on their location within the urinary system, these stones may be classified as either urolithiasis, when situated within the urinary tract, or nephrolithiasis, when located within the kidneys. Each term signifies the specific impact of the stone.Predisposition...