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Updated: May 15, 2026
06:05
Assessing Urinary Tract Junction Obstruction Defects by Methylene Blue Dye Injection
Published on: October 12, 2017
[Primary vesicoureteral reflux]
R Stein1, C Ziesel, P Rubenwolf
1Abteilung Kinderurologie der Urologischen Klinik und Poliklinik, Universitätsmedizin Mainz, Johannes Gutenberg-Universität Mainz. Raimund.Stein@unimedizin-mainz.de
Der Urologe. Ausg. A
|January 9, 2013
Summary
Vesicoureteral reflux (VUR) management balances preventing renal scars with patient burden. Diagnosis and treatment strategies for VUR are tailored to individual risk factors, including age, reflux severity, and bladder dysfunction.
Area of Science:
- Pediatric Urology
- Nephrology
- Diagnostic Imaging
Context:
- Vesicoureteral reflux (VUR) discussion includes diagnostic nihilism versus invasive approaches.
- Preventing renal scarring is the primary goal in VUR management.
- Distinguishing acquired reflux nephropathy from congenital dysplasia is crucial as only the former is treatable.
Purpose:
- To review current diagnostic and therapeutic strategies for VUR.
- To emphasize risk-adapted therapy based on patient factors.
- To discuss the role of bladder dysfunction as a VUR risk factor.
Summary:
- Diagnostic methods include voiding cystourethrography (VCUG), urosonography, radionuclide cystography, and MRI.
- European guidelines recommend VUR screening after the first febrile urinary tract infection (UTI).
- Risk factors for renal scarring include recurrent UTIs, parenchymal scarring, and dilating reflux; dysfunctional elimination syndrome is also a significant factor.
- Therapeutic decisions consider age, gender, renal scarring, clinical symptoms, bladder dysfunction, and UTI frequency/severity.
- Antibacterial prophylaxis and endoscopic therapy are debated alternatives to surveillance or surgery.
- Open surgical techniques offer the highest success rates for dilating VUR with high renal damage risk.
Impact:
- Informed clinical decision-making for VUR diagnostics and treatment.
- Optimized prevention of renal scarring in children with VUR.
- Improved patient outcomes through tailored, risk-adapted management strategies.
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