ABSTRACT
Vesicoureteral reflux refers to the retrograde flow of urine from the bladder into the ureter(s) with filling or voiding. Reflux in itself is benign, but the reflux of infected urine can lead to pyelonephritis and subsequent renal scarring. High-pressure reflux in patients with neurogenic bladder can also lead to renal injury. Because most cases of reflux resolve spontaneously over several years, the initial management of reflux is usually medical-preventing infections with antibiotic prophylaxis and treating underlying conditions such as constipation and voiding dysfunction that may predispose to urinary tract infections or propagate reflux. Surgical intervention is generally considered for children with breakthrough infections despite prophylaxis, children with highgrade reflux (which is unlikely to resolve spontaneously), or for children who cannot tolerate or comply with medical treatment and periodic testing.
