Skip to main content
SpringerLink
Log in

Vesicoureteral Reflux

  • Reference work entry
  • First Online:
Handbook of Neurourology

  • 432 Accesses

Abstract

Vesicoureteral reflux (VUR) in patients with neurogenic lower urinary tract dysfunction (NLUTD) can develop as a secondary complication of NLUTD, e.g., due to elevated intravesical pressures, or due to bladder wall fibrosis. Cystography remains the gold standard for diagnosis. High-grade VUR is regarded as a risk factor for recurrent pyelonephritis and reflux nephropathy pyelonephritis and renal scarring. In secondary VUR, treatment consists of treatment of neurogenic detrusor overactivity. The treatment of VUR is complex and special, with a variety of options, from active surveillance to surgical treatment. This chapter reviewed special aspects on VUR in different NLUTD to help clinicians identify VUR and choose appropriate methods to treat it.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 999.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 999.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. R.L. Lebowitz, H. Olbing, K.V. Parkkulainen, J.M. Smellie, T.E. Tamminen-Möbius, International system of radiographic grading of vesicoureteric reflux. International reflux study in children. Pediatr. Radiol. 15, 105–109 (1985)

    Article  CAS  PubMed  Google Scholar 

  2. C. Rollino, L. D’Urso, G. Beltrame, M. Ferro, G. Quattrocchio, F. Quarello, Vesicoureteral reflux in adults. G. Ital. Nefrol. 28, 599–611 (2011)

    PubMed  Google Scholar 

  3. A. Giannantoni, E. Mearini, M. Del Zingaro, M. Porena, Six-year follow-up of botulinum toxin A intradetrusorial injections in patients with refractory neurogenic detrusor overactivity: Clinical and urodynamic results. Eur. Urol. 55, 705–711 (2009)

    Article  CAS  PubMed  Google Scholar 

  4. F. Mascarenhas, M. Cocuzza, C.M. Gomes, N. Leão, Trigonal injection of botulinum toxin-A does not cause vesicoureteral reflux in neurogenic patients. Neurourol. Urodyn. 27, 311–314 (2008)

    Article  CAS  PubMed  Google Scholar 

  5. S.J. Foley, M.K. Sheriff, P.J. Shah, Endoscopic treatment of vesicoureteric reflux in adults with a neuropathic bladder. Spinal Cord 34, 657–658 (1996)

    Article  CAS  PubMed  Google Scholar 

  6. A.S. Polackwich, S.J. Skoog, J.C. Austin, Long-term follow-up after endoscopic treatment of vesicoureteral reflux with dextranomer/hyaluronic acid copolymer in patients with neurogenic bladder. J. Urol. 188, 1511–1515 (2012)

    Article  CAS  PubMed  Google Scholar 

  7. M.C. Vírseda, J.C. Salinas, E. Bolufer, M.F. Esteban, Endoscopic treatment of vesicoureteral reflux with non-simultaneous involuntary detrusor contraction in chronic spinal cord injury patients with neurogenic detrusor overactivity. Urol. Int. 93, 399–402 (2014)

    Article  PubMed  Google Scholar 

  8. A.J. Kirsch, A.M. Arlen, Evaluation of new Deflux administration techniques: Intraureteric HIT and double HIT for the endoscopic correction of vesicoureteral reflux. Expert Rev. Med. Devices 11, 439–446 (2014)

    Article  CAS  PubMed  Google Scholar 

  9. T.E. Helmy, A.T. Hafez, Vesicouretral reflux with neuropathic bladder: Studying the resolution rate after ileocystoplasty. Urology 82, 425–428 (2013)

    Article  PubMed  Google Scholar 

  10. J.N. Panicker, Neurogenic bladder: Epidemiology, diagnosis, and management. Semin. Neurol. 40(5), 569–579 (2020). https://doi.org/10.1055/s-0040-1713876. Epub 16 Oct 2020

    Article  PubMed  PubMed Central  Google Scholar 

  11. A.S. Blais, S. Bolduc, K. Moore, Vesicoureteral reflux: From prophylaxis to surgery. Can. Urol. Assoc. J. 11(1–2 Suppl 1), S13–S18. https://doi.org/10.5489/cuaj.4342

  12. C.Q. Wu, I. Franco, Management of vesicoureteral reflux in neurogenic bladder. Investig. Clin. Urol. 58(Suppl 1), S54–S58 (2017). https://doi.org/10.4111/icu.2017.58.S1.S54. Epub 2017 Jun 2

    Article  PubMed  PubMed Central  Google Scholar 

  13. S.P. Greenfield, Vesicoureteral reflux – Current treatment options. Expert Opin. Pharmacother. 4(11), 1959–1966 (2003). https://doi.org/10.1517/14656566.4.11.1959

    Article  PubMed  Google Scholar 

  14. C.R. Estrada Jr., C.C. Passerotti, D.A. Graham, et al., Nomograms for predicting annual resolution rate of primary vesicoureteral reflux: Results from 2,462 children. J. Urol. 182, 1535–1541 (2009)

    Article  PubMed  Google Scholar 

  15. P.J. Lopez, S. Celis, F. Reed, R. Zubieta, Vesicoureteral reflux: Current management in children. Curr. Urol. Rep. 15(10), 447 (2014). https://doi.org/10.1007/s11934-014-0447-9

    Article  PubMed  Google Scholar 

  16. L.A. Greenbaum, H.G. Mesrobian, Vesicoureteral reflux. Pediatr. Clin. N. Am. 53(3), 413–427, vi (2006). https://doi.org/10.1016/j.pcl.2006.02.010.

  17. T.F. Schöps, M.P. Schneider, F. Steffen, B.V. Ineichen, U. Mehnert, T.M. Kessler, Neurogenic lower urinary tract dysfunction (NLUTD) in patients with spinal cord injury: Long-term urodynamic findings. BJU Int. 115(Suppl 6), 33–38 (2015). https://doi.org/10.1111/bju.13085

    Article  PubMed  Google Scholar 

  18. C.A. Peters, S. Skoog, B. Arant, et al., Summary of the AUA guideline on management of primary vesicoureteral reflux in children. J. Urol. 184, 1134–1144 (2010)

    Article  PubMed  Google Scholar 

  19. S. Tekgül, H. Riedmiller, P. Hoebeke, R. Kočvara, R.J. Nijman, C. Radmayr, et al., EAU guidelines on vesicoureteral reflux in children. Eur. Urol. 62, 534–542 (2012)

    Article  PubMed  Google Scholar 

  20. Subcommittee on Urinary Tract Infection, Steering Committee on Quality Improvement and Management, K.B. Roberts, Urinary tract infection: Clinical practice guideline for the diagnosis and management of the initial UTI in febrile infants and children 2 to 24 months. Pediatrics 128, 595–610 (2011)

    Article  Google Scholar 

  21. R.L. Lebowitz, H. Olbing, K.V. Parkkulainen, et al., International system of radiographic grading of vesicoureteric reflux. International Reflux Study in Children. Pediatr. Radiol. 15(2), 105–109 (1985)

    Article  CAS  PubMed  Google Scholar 

  22. P. Hajiyev, B. Burgu, Contemporary management of vesicoureteral reflux. Eur. Urol. Focus 3(2–3), 181–188 (2017). https://doi.org/10.1016/j.euf.2017.08.012. Epub 2017 Sep 12

    Article  PubMed  Google Scholar 

  23. V. Fanos, L. Cataldi, Antibiotics or surgery for vesicoureteric reflux in children. Lancet 364(9446), 1720–1722 (2004). https://doi.org/10.1016/S0140-6736(04)17359-5

    Article  PubMed  Google Scholar 

  24. J.S. Elder, M. Diaz, Vesicoureteral reflux – The role of bladder and bowel dysfunction. Nat. Rev. Urol. 10(11), 640–648 (2013). https://doi.org/10.1038/nrurol.2013.221. Epub 2013 Oct 15

    Article  CAS  PubMed  Google Scholar 

  25. A. Hoberman, S.P. Greenfield, T.K. Mattoo, et al., Antimicrobial prophylaxis for children with vesicoureteral reflux. N. Engl. J. Med. 370, 2367–2376 (2014). https://doi.org/10.1056/NEJMoa1401811

    Article  CAS  PubMed  Google Scholar 

  26. S. Tekgül, H. Riedmiller, P. Hoebeke, et al., EAU guidelines on vesicoureteral reflux in children. Eur. Urol. 62, 534–542 (2012)

    Article  PubMed  Google Scholar 

  27. K. Moriya, T. Mitsui, T. Kitta, et al., Discontinuation of antibiotic prophylaxis in patients with persistent primary vesicoureteral reflux initially detected during infancy: Outcome analysis and risk factors for febrile urinary tract infection. J. Urol. 193, 637–642 (2015)

    Article  PubMed  Google Scholar 

  28. M. Stöhrer, B. Blok, D. Castro-Diaz, E. Chartier-Kastler, G. Del Popolo, G. Kramer, J. Pannek, P. Radziszewski, J.J. Wyndaele, EAU guidelines on neurogenic lower urinary tract dysfunction. Eur. Urol. 56(1), 81–88 (2009). https://doi.org/10.1016/j.eururo.2009.04.028. Epub 2009 Apr 21

    Article  PubMed  Google Scholar 

  29. S.B. Bauer, Neurogenic bladder: Etiology and assessment. Pediatr. Nephrol. 23, 541–551 (2008)

    Article  PubMed  PubMed Central  Google Scholar 

  30. M. Kaefer, A. Pabby, M. Kelly, M. Darbey, S.B. Bauer, Improved bladder function after prophylactic treatment of the high risk neurogenic bladder in newborns with myelomentingocele. J. Urol. 162(3 Pt 2), 1068–1071 (1999)

    Article  CAS  PubMed  Google Scholar 

  31. M. Perez-Brayfield, A.J. Kirsch, T.W. Hensle, M.A. Koyle, P. Furness, H.C. Scherz, Endoscopic treatment with dextranomer/hyaluronic acid for complex cases of vesicoureteral reflux. J. Urol. 172(4 Pt 2), 1614–1616 (2004)

    Article  CAS  PubMed  Google Scholar 

  32. J.D. Engel, L.S. Palmer, E.Y. Cheng, W.E. Kaplan, Surgical versus endoscopic correction of vesicoureteral reflux in children with neurogenic bladder dysfunction. J. Urol. 157, 2291–2294 (1997)

    Article  CAS  PubMed  Google Scholar 

  33. C. Granata, P. Buffa, E. Di Rovasenda, G. Mattioli, P.L. Scarsi, E. Podesta, et al., Treatment of vesico-ureteric reflux in children with neuropathic bladder: A comparison of surgical and endoscopic correction. J. Pediatr. Surg. 34, 1836–1838 (1999)

    Article  CAS  PubMed  Google Scholar 

  34. K.F. Neel, M. Salem, S. Soliman, Total endoscopic management (TEM approach) of children with non-compliant neuropathic bladder: A preliminary report. J. Pediatr. Urol. 4, 124–126 (2008)

    Article  PubMed  Google Scholar 

  35. D.R. Vandersteen, J.C. Routh, A.J. Kirsch, H.C. Scherz, M.L. Ritchey, E. Shapiro, et al., Postoperative ureteral obstruction after subureteral injection of dextranomer/hyaluronic acid copolymer. J. Urol. 176(4 Pt 1), 1593–1595 (2006)

    Article  CAS  PubMed  Google Scholar 

  36. Y. Hayashi, Y. Kato, T. Okazaky, et al., The effectiveness of ureteric reimplantation during bladder augmentation for high-grade vesicouretericreflflux in patients with neurogenic bladder: Long-term outcome. J. Pediatr. Surg. 42, 1998–2001 (2007)

    Article  PubMed  Google Scholar 

  37. M. Riccabona, M. Koen, M. Schindler, et al., Botulinum-A toxin injection into the detrusor: A safe alternative in the treatment of children with myelomeningocele with detrusor hyperreflflexia. J. Urol. 171, 845–848 (2004)

    Article  CAS  PubMed  Google Scholar 

  38. G. Mosiello, M.L. Salsano, M.P. Pascali, D. Camanni, M. De Gennaro, A minimally invasive approach in the treatment of vesicoureteral reflux in neurogenic bladder in children. Eur. Urol. 55(1), 254–256 (2009). https://doi.org/10.1016/j.eururo.2008.07.030. Epub 2008 Jul 18

    Article  PubMed  Google Scholar 

  39. D. Liberman, M.J. Ehlert, S.W. Siegel, Sacral neuromodulation in urological practice. Urology 99, 14–22 (2017). https://doi.org/10.1016/j.urology.2016.06.004. Epub 2016 Jun 11

    Article  PubMed  Google Scholar 

  40. T.M. Kessler, D. La Framboise, S. Trelle, C.J. Fowler, G. Kiss, J. Pannek, B. Schurch, K.D. Sievert, D.S. Engeler, Sacral neuromodulation for neurogenic lower urinary tract dysfunction: Systematic review and meta-analysis. Eur. Urol. 58(6), 865–874 (2010). https://doi.org/10.1016/j.eururo.2010.09.024. Epub 2010 Oct 1

    Article  PubMed  Google Scholar 

  41. G. Chen, L. Liao, Y. Wang, X. Ying, Urodynamic findings during the filling phase in neurogenic bladder patients with or without vesicoureteral reflux who have undergone sacral neuromodulation. Neurourol. Urodyn. 39(5), 1410–1416 (2020). https://doi.org/10.1002/nau.24354. Epub 2020 Apr 13

    Article  PubMed  Google Scholar 

  42. J.C. Austin, C.S. Cooper, Vesicoureteral reflux: Surgical approaches. Urol. Clin. North Am. 31(3), 543–557, x (2004). https://doi.org/10.1016/j.ucl.2004.04.018

    Article  PubMed  Google Scholar 

  43. A. Morioka, T. Miyano, K. Ando, T. Yamataka, G.J. Lane, Management of vesicoureteral reflux secondary to neurogenic bladder. Pediatr. Surg. Int. 13, 584–586 (1998)

    Article  CAS  PubMed  Google Scholar 

  44. N. Simforoosh, A. Tabibi, A. Basiri, M.H. Noorbala, A.D. Danesh, A. Ijadi, Is ureteral reimplantation necessary during augmentation cystoplasty in patients with neurogenic bladder and vesicoureteral reflux? J. Urol. 168(4 Pt 1), 1439–1441 (2002)

    Article  PubMed  Google Scholar 

  45. P.F. Nasrallah, H.A. Aliabadi, Bladder augmentation in patients with neurogenic bladder and vesicoureteral reflux. J. Urol. 146(2 Pt 2), 563–566 (1991)

    Article  CAS  PubMed  Google Scholar 

  46. H.C. Zhang, J. Yang, X. Ye, H.F. Hu, Augmentation enterocystoplasty without reimplantation for patients with neurogenic bladder and vesicoureteral reflux. Kaohsiung J. Med. Sci. 32, 323–326 (2016)

    Article  PubMed  Google Scholar 

  47. Z. Wang, L. Liao, Effectiveness and complications of augmentation cystoplasty with or without nonrefluxing ureteral reimplantation in patients with bladder dysfunction: A single center 11-year experience. J. Urol. 199(1), 200–205 (2018). https://doi.org/10.1016/j.juro.2017.07.073. Epub 2017 Jul 23

    Article  PubMed  Google Scholar 

  48. F. Zhang, L. Liao, Sigmoidocolocystoplasty with ureteral reimplantation for treatment of neurogenic bladder. Urology 80, 440 (2012)

    Article  CAS  PubMed  Google Scholar 

  49. L. Liao, F. Zhang, G. Chen, Midterm outcomes of protection for upper urinary tract function by augmentation enterocystoplasty in patients with neurogenic bladder. Int. Urol. Nephrol. 46, 2117 (2014)

    Article  CAS  PubMed  Google Scholar 

  50. X. Ying, L. Liao, Augmentation uretero-enterocystoplasty for refractory urinary tract dysfunction: A long-term retrospective study. BMC Urol. (2021). https://doi.org/10.1186/s12894-021-00927-z

  51. Zhou Z, Wang X, Liao L. The concerns of mechanical upper urinary tract obstruction in neurogenic lower urinary tract dysfunction: Beyond augmentation cystoplasty. Front Surg. 2023 Mar 23;10:1102272. https://doi.org/10.3389/fsurg.2023.1102272. PMID: 37035566; PMCID: PMC10076626.

  52. A.T. Hafez, G. McLorie, D. Gilday, B. Laudenberg, J. Upadhyay, D. Bagli, et al., Long-term evaluation of metabolic profile and bone mineral density after ileocystoplasty in children. J. Urol. 170(4 Pt 2), 1639–1641 (2003)

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Swiss Paraplegic Center, Nottwil, Switzerland

    Jürgen Pannek

  2. Department of Urology and Department of Neurourology, China Rehabilitation Research Center, China Rehabilitation Science Institute, Capital Medical University, Beijing, China

    Limin Liao

Authors
  1. Jürgen Pannek
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Limin Liao
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Limin Liao .

Editor information

Editors and Affiliations

  1. Department of Urology Department of Neurourology, China Rehabiliation Research Center China Rehabilitation Science InstituteCapital Medical University, Beijing, China

    Limin Liao

  2. Department of Urology, Medical University Innsbruck, University Hospital, Innsbruck, Austria

    Helmut Madersbacher

Rights and permissions

Reprints and permissions

Copyright information

© 2023 Springer Nature Singapore Pte Ltd.

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Pannek, J., Liao, L. (2023). Vesicoureteral Reflux. In: Liao, L., Madersbacher, H. (eds) Handbook of Neurourology. Springer, Singapore. https://doi.org/10.1007/978-981-99-1659-7_76

Download citation

  • DOI: https://doi.org/10.1007/978-981-99-1659-7_76

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-99-1658-0

  • Online ISBN: 978-981-99-1659-7

  • eBook Packages: MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation