Related Experiment Video
Updated: Jun 28, 2026
Assessing Urinary Tract Junction Obstruction Defects by Methylene Blue Dye Injection
Published on: October 12, 2017
Bladder dysfunction and vesicoureteral reflux
1Pediatric Uronephrologic Center (PUNC), Queen Silvia Children's Hospital, The Sahlgrenska Academy at University of Gothenburg, 416 85 Gothenburg, Sweden. ulla.sillen@vgregion.se
Insights
Treating functional bladder disturbances like overactive bladder (OAB) and dysfunctional voiding (DV) in children with vesicoureteral reflux (VUR) has mixed results. Evidence suggests DV negatively impacts VUR resolution, unlike OAB, necessitating further research.
Area of Science:
- Pediatric Urology
- Pediatric Nephrology
- Functional Urology
Background:
- Functional bladder disturbances, including overactive bladder (OAB) and dysfunctional voiding (DV), are historically linked to pediatric vesicoureteral reflux (VUR).
- Previous assumptions suggested that treating these bladder dysfunctions positively influenced the spontaneous resolution of VUR.
Purpose of the Study:
- To review the current evidence on the impact of functional bladder disturbances and their treatments on the resolution of VUR in children.
- To clarify the relationship between OAB, DV, and VUR resolution rates.
Main Methods:
- Literature review and synthesis of existing studies examining the influence of bladder dysfunction and its treatment on VUR resolution.
- Analysis of prospective studies, uncontrolled trials, and observational data.
Main Results:
- Treatment for OAB with anticholinergics did not significantly affect the spontaneous resolution rate of VUR.
- Most studies indicate that DV and dysfunctional elimination syndrome (DES) negatively impact VUR resolution, regardless of treatment or age.
- Uncontrolled studies suggest potential short-term VUR resolution with flow biofeedback for DV, but these findings require robust validation.
Conclusions:
- Voiding phase dysfunctions (DV and DES) are more severe than OAB, associated with higher risks of urinary tract infections and renal damage.
- Current evidence is insufficient to definitively conclude whether treating bladder dysfunction influences VUR resolution rates in children.
- Randomized controlled trials are essential to establish the efficacy of treating bladder dysfunction on VUR resolution in pediatric populations.
Abstract:
In this overview the influence of functional bladder disturbances and of its treatment on the resolution of vesicoureteral reflux (VUR) in children is discussed. Historically both bladder dysfunction entities, the overactive bladder (OAB) and the dysfunctional voiding (DV), have been described in conjunction with VUR. Treatment of the dysfunction was also considered to influence spontaneous resolution in a positive way. During the last decades, however, papers have been published which could not support these results. Regarding the OAB, a prospective study with treatment of the bladder overactivity with anticholinergics, did not influence spontaneous resolution rate in children with a dysfunction including also the voiding phase, DV and DES (dysfunctional elimination syndrome), most studies indicate a negative influence on the resolution rate of VUR in children, both before and after the age for bladder control, both with and without treatment. However, a couple of uncontrolled studies indicate that there is a high short-term resolution rate after treatment with flow biofeedback. It should be emphasized that the voiding phase dysfunctions (DV and DES) are more severe than the genuine filling phase dysfunction (OAB), with an increased frequency of UTI and renal damage in the former groups. To be able to answer the question if treatment of bladder dysfunction influence the resolution rate of VUR in children, randomized controlled studies must be performed.
More Related Videos
Related Concept Videos
01:20Disorders of the Urinary System
Urinary tract infections (UTIs) are one of the most common urinary system disorders. They are caused by bacteria that enter the urethra and can spread to the bladder resulting in cystitis. Pyelonephritis is the result of a UTI that has ascended to the level of the...
01:22Imaging Studies VI: Voiding Cystourethrography and Cystography
01:19Anatomy of the Genitourinary System II: Bladder and Urethra
01:26The Micturition Reflex
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...
01:26Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations
01:23Urinary Bladder
In males, the bladder is situated in front of the rectum, while in females, it is positioned anterior to the vagina and uterus. The bladder floor contains an inverted triangular area called the trigone, defined by the two ureteric...