Medscape is available in 5 Language Editions – Choose your Edition here.


Pediatric Vesicoureteral Reflux Differential Diagnoses

  • Author: Caleb P Nelson, MD, MPH; Chief Editor: Marc Cendron, MD  more...
Updated: May 31, 2016
Contributor Information and Disclosures

Caleb P Nelson, MD, MPH Assistant Professor of Surgery (Urology), Department of Urology, Harvard Medical School; Consulting Staff, Department of Urology, Children's Hospital Boston

Caleb P Nelson, MD, MPH is a member of the following medical societies: American Urological Association, Endourological Society, Phi Beta Kappa, Society for Pediatric Urology, Society for Fetal Urology

Disclosure: Nothing to disclose.


Harry P Koo, MD Chairman of Urology Division, Director of Pediatric Urology, Professor of Surgery, Virginia Commonwealth University School of Medicine, Medical College of Virginia; Director of Urology, Children's Hospital of Richmond

Harry P Koo, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Surgeons, American Urological Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Martin David Bomalaski, MD, FAAP Pediatric Urologist, Alaska Urology; Clinical Assistant Professor, Seattle Children's Hospital

Martin David Bomalaski, MD, FAAP is a member of the following medical societies: Alpha Omega Alpha, American Academy of Pediatrics, American Urological Association

Disclosure: Nothing to disclose.

Chief Editor

Marc Cendron, MD Associate Professor of Surgery, Harvard School of Medicine; Consulting Staff, Department of Urological Surgery, Children's Hospital Boston

Marc Cendron, MD is a member of the following medical societies: American Academy of Pediatrics, American Urological Association, New Hampshire Medical Society, Society for Pediatric Urology, Society for Fetal Urology, Johns Hopkins Medical and Surgical Association, European Society for Paediatric Urology

Disclosure: Nothing to disclose.

Additional Contributors

Bartley G Cilento, Jr, MD Instructor, Department of Surgery, Division of Urology, Children's Hospital of Boston and Harvard Medical School

Bartley G Cilento, Jr, MD is a member of the following medical societies: American Academy of Pediatrics, American Urological Association, Massachusetts Medical Society

Disclosure: Nothing to disclose.

  1. Roberts KB. Urinary tract infection: clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months. Pediatrics. 2011 Sep. 128(3):595-610. [Medline].

  2. Weiss R, Duckett J, Spitzer A. Results of a randomized clinical trial of medical versus surgical management of infants and children with grades III and IV primary vesicoureteral reflux (United States). The International Reflux Study in Children. J Urol. 1992 Nov. 148(5 Pt 2):1667-73. [Medline].

  3. Walker RD. Vesicoureteral reflux and urinary tract infection in children. Gillenwater JY, Grayhack JT, eds. Adult and Pediatric Urology. 3rd ed. Mosby-Year Book; 1996. 2259-96.

  4. RIVUR Trial Investigators, Hoberman A, Greenfield SP, Mattoo TK, Keren R, Mathews R, et al. Antimicrobial prophylaxis for children with vesicoureteral reflux. N Engl J Med. 2014 Jun 19. 370 (25):2367-76. [Medline]. [Full Text].

  5. Academy of Pediatrics. Committee on Quality Improvement. Subcommittee on UTI. Practice parameter: the diagnosis, treatment, and evaluation of the initial urinary tract infection in febrile infants and young children. Pediatrics. 1999 Apr. 103(4 Pt 1):843-52. [Medline].

  6. Smellie JM, Prescod NP, Shaw PJ, et al. Childhood reflux and urinary infection: a follow-up of 10-41 years in 226 adults. Pediatr Nephrol. 1998 Nov. 12(9):727-36. [Medline].

  7. Ransley PG, Risdon RA. Reflux nephropathy: effects of antimicrobial therapy on the evolution of the early pyelonephritic scar. Kidney Int. 1981 Dec. 20(6):- Risdon RA. [Medline].

  8. Hunziker M, Colhoun E, Puri P. Renal cortical abnormalities in siblings of index patients with vesicoureteral reflux. Pediatrics. 2014 Apr. 133(4):e933-7. [Medline].

  9. Nelson CP, Johnson EK, Logvinenko T, Chow JS. Ultrasound as a screening test for genitourinary anomalies in children with UTI. Pediatrics. 2014 Mar. 133(3):e394-403. [Medline].

  10. Broadis E, Kronfli R, Flett ME, Cascio S, O'Toole SJ. 'Targeted top down' approach for the investigation of UTI: A 10-year follow-up study in a cohort of 1000 children. J Pediatr Urol. 2016 Feb. 12 (1):39.e1-6. [Medline].

  11. Lee YJ, Lee JH, Park YS. Risk Factors for Renal Scar Formation in Infants With First Episode of Acute Pyelonephritis: A Prospective Clinical Study. J Urol. 2012 Jan 18. [Medline].

  12. Edmondson JD, Maizels M, Alpert SA, Kirsch AJ, Hanna MK, Weiser AC, et al. Multi-institutional experience with PIC cystography--incidence of occult vesicoureteral reflux in children with febrile urinary tract infections. Urology. 2006 Mar. 67(3):608-11. [Medline].

  13. Routh JC, Inman BA, Reinberg Y. Dextranomer/hyaluronic acid for pediatric vesicoureteral reflux: systematic review. Pediatrics. 2010 May. 125(5):1010-9. [Medline].

  14. Elder JS, Diaz M, Caldamone AA, et al. Endoscopic therapy for vesicoureteral reflux: a meta-analysis. I. Reflux resolution and urinary tract infection. J Urol. 2006 Feb. 175(2):716-22. [Medline].

  15. Kocaoglu C. Endoscopic treatment of grades IV and V vesicoureteral reflux with two bulking substances: Dextranomer hyaluronic acid copolymer versus polyacrylate polyalcohol copolymer in children. J Pediatr Surg. 2016 Apr 9. [Medline].

  16. De Badiola FI, Soria R, Vagni RL, Ormaechea MN, Moldes JM, Benmaor C. Results of Treatment of Grades IV and V Vesicoureteral Reflux with Endoscopic Injection of Polyacrylate Polyalcohol Copolymer. Front Pediatr. 2013. 1:32. [Medline].

  17. Arlen AM, Scherz HC, Filimon E, Leong T, Kirsch AJ. Is routine voiding cystourethrogram necessary following double hit for primary vesicoureteral reflux?. J Pediatr Urol. 2015 Feb. 11 (1):40.e1-5. [Medline].

All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.