Chronic lower quadrant abdominal pain due to vesicoureteral reflux

Chronic lower abdominal pain or flank pain in adults may be associated with vesicoureteral reflux. Although it is well known that renal scarring may occur in adults with vesicoureteral reflux associated with urinary tract infection, renal function may vary significantly when these patients are found to have sterile vesicoureteral reflux. We report 2 cases of lifelong intermittent lower abdominal pain associated with vesicoureteral reflux without damage to the upper urinary tracts. A voiding cystourethrogram should be included in the evaluation of adults with chronic lower quadrant pain or flank pain even if excretory urography and cystoscopy are normal and the urine is sterile.