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General Medical Questions
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Question : My 3-month-old granddaughter has been diagnosed with urine reflux. What might we expect?
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The Trusted Source
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Howard LeWine, M.D.

Henry H. Bernstein, D.O., is a senior lecturer in Pediatrics at Harvard Medical School. In addition, he is chief of General Academic Pediatrics at Children's Hospital at Dartmouth and professor of pediatrics at Dartmouth Medical School. He is the former associate chief of General Pediatrics and director of Primary Care at Children's Hospital Boston.

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July 01, 2013
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Normally, urine is made in the kidneys, travels down tubes called ureters and empties into the bladder before it comes out of the body. This should be a "one way" system. However, with the condition vesicoureteral reflux (VUR), urine travels the "wrong way" – from the bladder back up into the ureters and kidneys.

VUR can be serious. An infection of the urine in the bladder can travel back up the ureters into the kidneys. This leads to kidney damage.

The first signs of VUR are sometimes seen on a prenatal ultrasound, even before a baby is born. This abnormal prenatal ultrasound might show enlargement (dilation) of part of the kidney, called "hydronephrosis." On the other hand, a baby's ultrasound can be normal, and the first sign of VUR may be a urinary tract infection.

The severity of VUR can vary. It depends on how much urine goes back up into the kidneys.

The diagnosis is made by a test called a Voiding Cystourethrogram (VCUG). In this test, dye is put into the bladder using a small catheter. Then X-rays are taken to see if the dye travels the "wrong way" back up into the kidneys.

Some children need to take a daily antibiotic to prevent infection that might lead to kidney damage. But most children with reflux don't need it, especially those with mild reflux. Very severe cases require surgery to prevent the reflux.

Many cases of VUR get better on their own, especially if the reflux is mild or if the reflux is only on one side.

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