VUR is a common childhood congenital urinary anomaly

Vesicoureteral reflux (VUR), commonly referred to as urinary reflux, is the most common congenital urinary anomaly to occur during childhood.¹It is defined as the abnormal retrograde flow of urine from the bladder into the upper urinary tract through an incompetent ureterovesical junction.²

The prevalence of reflux varies with several demographic factors of the patient population. Reflux may occur as an isolated entity or with other associated anomalies of the genitourinary tract.²

Urinary reflux usually presents during the first few years of life.³ Up to 1.8% of all children are affected by VUR.⁴

What puts a child at risk for VUR?

History of urinary tract Infections (UTIs)

• Less than 1% in children without urologic symptoms or history of infection²
• 20-50% in children with a history of symptomatic urinary tract infection²
• About 40% of children with a UTI under 24 months have VUR³

Sibling or child of a person with VUR

• Siblings of individuals diagnosed with VUR have about a 35% probability of developing VUR⁵
• The children of individuals diagnosed with VUR have up to a 50% chance of developing VUR^5,6

Age, gender, ethnicity
The prototypical patient with VUR is a Caucasian girl younger than 4 years of age with a history of UTIs^3,4

• Average VUR diagnosis occurs between 2-3 years old⁵
• 80% of children evaluated for a UTI and diagnosed with VUR are girls⁵
• Light skinned children are at greater risk for VUR, compared with black children and children of Mediterranean origin²

Due to the epidemiology of UTIs in children, boys and girls may present with VUR at different ages.² UTIs are more common in uncircumcised boys than girls during the neonatal period, therefore many boys will be diagnosed with reflux in the neonatal period.² However, after the first year of life, the incidence of UTIs is much higher in girls than boys. Therefore, more school-aged children diagnosed with VUR are girls.²

Associated anomalies²

• Posterior urethral valves
• Duplicated collecting system
• Prune belly (Eagle-Barrett) syndrome
• Bladder exstrophy
• Severe voiding dysfunction
• Neurogenic bladder
• Ureterocele

For distended kidney, VUR is often identified prenatally or younger than one year old and is most often associated with boys⁴