Mild VUR does not usually need any treatment and most children grow out of it in a few years.
Treatment may be needed if your child has recurrent urinary tract infections (UTIs) or if the VUR is more severe.
Where will my child be treated?
Your child may be referred to hospital to see a paediatrician, a doctor who treats babies, children and young people.
Some babies and children with high-grade (severe) VUR or reflux nephropathy are referred to a paediatric nephrologist, a doctor who treats children with kidney problems.
Sometimes children are referred to a paediatric urologist, a surgeon who treats children with problems of the urinary system. The urologist will assess your child and consider whether surgical treatment is needed.
Preventing and treating urinary tract infections
It is important to treat UTIs quickly when they do happen.
Preventing UTIs
Children with high-grade VUR may benefit from taking a small dose of antibiotic medicine once a day – this is called a prophylactic antibiotic. Antibiotics kill bacteria (germs) that cause UTIs and so help prevent these infections.
Treating UTIs
Sometimes UTIs can happen even when your child is taking these antibiotics. It is important that UTIs are diagnosed and treated quickly to try to prevent them causing kidney damage. If you think your child has a UTI, contact your doctor or local NHS services.
Always follow your healthcare team’s advice on how much medication to give your child.
Controlling blood pressure
It is important that your child’s blood pressure is in a healthy range, to help keep their kidneys healthy. If your child has high blood pressure hypertension, they may need be prescribed medication to lower their blood pressure.
More about hypertension and how to control blood pressure
Reducing protein loss in urine
If your child’s urine tests show proteinuria (more protein in the urine than normal), they may need medication to reduce the amount of protein lost in their urine and so protect the kidneys.
Reflux nephropathy
The scarring in reflux nephropathy cannot be treated.
Surgery
Surgery may be needed in rare cases if your child has severe VUR and recurrent UTIs.
Endoscopic anti-reflux surgery
A special gel is inserted into the end of the ureter within the bladder using a cystoscope (like a tiny telescope). This narrows the space, preventing urine refluxing out of the bladder, without blocking urine flowing into the bladder.
This is a quick procedure that is done under a general anaesthetic, and your child can usually go home the same day. Your child may be prescribed antibiotics to prevent or treat any infection caused by the cystoscopy.
Ureteric reimplantation
Very occasionally, another operation called ureteric reimplantation is recommended. This procedure re-tunnels the ureter into the bladder to create an anti-reflux mechanism.
A thin flexible tube called a catheter is placed through the urethra to drain urine from the bladder. It is left in place for a few days until your child can pass urine on their own.
This surgery is done under general anaesthesia, so your child can sleep through the procedure and not feel any pain.
Monitoring and follow up
In many children, VUR will disappear as they grow up. Most children have no symptoms from VUR or reflux nephropathy after the age of 5.
Your child will be able to do all of the things that other children their age do. Your child should be able to go to nursery and school, play with other children and stay active.
A very small number of children, especially those with high-grade (severe) VUR and/or bilateral reflux nephropathy, can develop chronic kidney disease (CKD). Your child will have regular blood, urine and blood pressure tests to check how well their kidneys are working.
For more information on VUR visit https://eric.org.uk/
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