Normally, urine travels from the kidneys to the bladder via the
ureters. Vesicoureteral reflux (VUR) occurs when urine that dwells in
the bladder flows back into the ureters and often back into the
kidneys. Children with VUR may present before birth as prenatal
hydronephrosis (an abnormal widening of the ureter) or with a urinary
tract infection. Some may be diagnosed because of a family history,
even though they may be without symptoms. Others have VUR secondary
to others abnormalities of the urinary tract such as posterior
urethral valves, ureterocele and neurogenic bladder. During infancy,
primary VUR is more common among boys because there is more pressure
in their urinary tract; in early childhood, the abnormality is more
common in girls. The concern with vesicoureteral reflux is that it
can lead to damage or scarring of the kidneys when the reflux is
associated with urinary tract infections. Treatment for VUR is based
on the child’s age, overall health, and medical history, the extent
of the condition, the child’s tolerance for specific medications,
procedures, or therapies, and expectations for the course of the
condition.