Treating VUR

What are the treatment options for VUR?

Vesicoureteral reflux (VUR) may necessitate a referral to a pediatric urologist, particularly for more severe cases that are not likely to spontaneously resolve.

A variety of treatment options are available for VUR:

Surveillance
Description Monitor for symptoms of UTI
Use Lowest grades; males less than 1 year old, low risk
Antibiotic Prophylaxis
Description Low, daily dose of oral antibiotics
Use Immediate and shorter-term prevention of UTI
Endoscopic Treatment With Deflux
Description Minimally invasive endoscopic procedure
Use Treatment of VUR grades II-IV
Surgical: Ureteral Reimplantation
Description Open surgical procedure
Use Highest grades based on individual patient needs

Some children may only require surveillance for potential febrile UTIs, with antibiotic therapy started if an acute UTI is diagnosed.1 Others may benefit from surgery to correct VUR. A pediatric urologist can determine whether a procedure is optimal based on many clinical factors.

Two procedures are available:

Minimally-invasive endoscopic treatment with Deflux for grades II-IV

  • Deflux is the preferred and most often used treatment among providers in academic settings for long-term cure of reflux.2

Ureteral reimplantation (also known as “open surgery”)

  • Children with very severe reflux can be candidates for ureteral reimplantation
References:
  1. Peters CA, Skoog SJ, Arant BS Jr, et al. Summary of the AUA guideline on management of primary vesicoureteral reflux in children. J Urol. 2010;184(3):1134-1144.
  2. Osumah T, Gearman D, Ahmed M, et al. Preference and use of minimally-invasive techniques in vesicoureteral reflux: correlating a crowdsourced survey and American board of urology case logs. J Urol. 2019;201(4S):e945.