Vesicoureteral Reflux Clinical Presentation

Updated: Dec 14, 2018
  • Author: Carlos Roberto Estrada, Jr, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Presentation

History

Vesicoureteral reflux (VUR) may be suspected in the prenatal period, when transient dilatation of the upper urinary tract is noted in conjunction with bladder emptying. Approximately 10% of neonates diagnosed prenatally with dilatation of the upper urinary tract will be found to have reflux postnatally. It should be noted that VUR cannot be diagnosed prenatally.

In general, VUR does not cause any specific signs or symptoms unless complicated by urinary tract infection (UTI). In other words, VUR is almost always asymptomatic unless it has led to a kidney infection (febrile UTI). Clinical signs and symptoms associated with a febrile UTI in a neonate may include irritability, persistent high fever, and listlessness. In cases of VUR and febrile UTI associated with a serious underlying urinary tract abnormality, the neonate could present with respiratory distress, failure to thrive, renal failure, flank masses, and urinary ascites.

Older children may more clearly communicate signs and symptoms associated with a UTI (eg, urgency, frequency, dysuria, incontinence), but unless the UTI is associated with a fever, there is little reason to suspect VUR.