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Congenital vesicoureterorenal reflux

Last edited: 4/10/2026

Overview

Congenital vesicoureteric reflux (VUR) is a condition diagnosed following investigation of prenatally detected urinary tract dilatation 1. It often remains asymptomatic but can cause parental and medical anxiety 1. The natural history of VUR diagnosed prenatally may differ from that diagnosed after recurrent febrile urinary tract infections (UTIs) 1.

Diagnosis

  • VUR is diagnosed following investigation of prenatally detected urinary tract dilatation 1.
  • VUR is graded from I to V 1.
  • DMSA scans can assess renal uptake defects 1.

    • Management

  • The benefit of continuous antibiotic prophylaxis (CAP) in asymptomatic infants with VUR is not conclusively established due to a lack of strong comparator cohorts 1.
  • A systematic review of asymptomatic infants found that 15.4% developed breakthrough UTIs despite CAP from birth 1.
  • Studies on VUR management have often included both prenatally diagnosed and symptomatic patients, confounding results 1.

    • Special Populations

  • VUR diagnosed following prenatal urinary tract dilatation is often noted in predominantly male infants 1.
  • High-grade VUR (IV-V) and established renal uptake defects on DMSA are characteristics of some infants diagnosed with VUR following prenatal hydronephrosis 1.

    • Key Recommendations

  • The true natural history of VUR diagnosed following prenatal urinary tract dilatation is not well-known due to limited studies focusing specifically on asymptomatic cohorts 1.
  • The benefit of continuous antibiotic prophylaxis (CAP) in asymptomatic infants with VUR is not conclusively established, with limited data showing no clear advantage 1.
  • Studies on VUR management and outcomes have historically confounded results by including both prenatally diagnosed and symptomatic patients 1.

    • References

    1 Farrugia MK, Montini G. Does vesicoureteric reflux diagnosed following prenatal urinary tract dilatation need active management? A narrative review. Journal of pediatric urology 2025. link

    Original source

    1. [1]
      Does vesicoureteric reflux diagnosed following prenatal urinary tract dilatation need active management? A narrative review. — Farrugia MK, Montini G Journal of pediatric urology (2025)
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