What is vesicoureteric reflux (VUR)?

VUR is the backward flow of urine from the bladder into the ureter and sometimes up to the kidney. It is common in children and can increase the risk of urinary tract infections and kidney scarring if not evaluated and managed appropriately.

How is VUR diagnosed?

Diagnosis typically involves a urine culture for infections, kidney and bladder ultrasound, and a micturating cystourethrogram (MCU/VCUG) which visualises reflux during bladder filling and voiding. A DMSA scan may be used to detect kidney scarring and assess renal cortical damage.

What do the VUR grades (I to V) mean?

VUR grading ranges from I (mild, reflux into ureter only) to V (severe, gross dilatation of ureter and renal pelvis). Higher grades have a greater risk of kidney damage and are less likely to resolve on their own.

When is conservative treatment appropriate?

Conservative management with antibiotic prophylaxis, close growth and infection monitoring, and periodic imaging is often chosen for low-grade VUR (grades I–II, and some grade III) especially in younger children, when the kidneys show no scarring and infections are controlled.

What is endoscopic injection (STING) and when is it used?

Endoscopic subureteric injection (STING) is a minimally invasive day-care procedure where a bulking agent is injected under the ureteric orifice to prevent reflux. It is commonly used for low–moderate grade VUR or when parents prefer a less invasive option and when anatomy is suitable.

When is ureteric reimplantation (surgery) recommended?

Surgery is recommended for persistent high-grade VUR (grades IV–V), recurrent febrile UTIs despite prophylaxis, progressive renal scarring or when conservative and endoscopic measures fail. Reimplantation can be performed via open, laparoscopic or robotic approaches depending on the case and available resources.

Can VUR cause kidney damage and how is scarring detected?

Recurrent febrile urinary infections combined with VUR can lead to renal cortical scarring, which may impair kidney function. A DMSA renal scan is the gold-standard test to detect scarring. Early detection and treatment of infections reduce this risk.

Do siblings of a child with VUR need screening?

Because of familial tendency, siblings (especially brothers and sisters under 2–5 years) may be offered ultrasound and, in selected circumstances, MCU screening after discussion with the paediatrician/urologist. Screening depends on family history, symptoms and local protocols.

How effective is STING injection compared to surgery?

STING injection has good success rates for low–moderate grade VUR and is less invasive, but multiple injections may be needed and long-term success is variable. Surgical ureteric reimplantation has higher definitive success rates for higher-grade or complex reflux.

What follow-up is needed after treatment for VUR?

Follow-up includes monitoring for urinary infections, periodic ultrasound and sometimes repeat MCU/VCUG or DMSA scans depending on initial severity and treatment. Semiquantitative assessment of growth, blood pressure and renal function may be advised in long-term follow-up for significant cases.

Can adults have VUR and is treatment different?

Yes — VUR can persist into adulthood or present later. Management is individualized: adults with recurrent UTIs, renal scarring or persistent high-grade reflux may be offered endoscopic or surgical correction; conservative care is possible in selected low-risk adults.

How do I book an appointment for VUR evaluation in Gomti Nagar Extension, Lucknow?

Call or WhatsApp Swastik Urology Clinic at +91 6387212291 to schedule a consultation with Dr. Aditya Sengar for assessment, imaging and a tailored treatment plan.

Vesicoureteric Reflux (VUR) Treatment in Gomti Nagar Extension, Lucknow

VUR (Vesicoureteric Reflux) Care in Gomti Nagar Extension, Lucknow – Swastik Urology Clinic

Vesicoureteric reflux (VUR) is a condition where urine flows backward from the bladder into the ureter and sometimes to the kidney. Early recognition and appropriate management are important to prevent recurrent urinary tract infections (UTIs) and protect the developing kidneys. At Swastik Urology Clinic, under the guidance of Dr. Aditya Sengar (Urologist), we provide evidence-based, child-friendly and adult-focused care — from diagnosis and conservative strategies to minimally invasive and reconstructive surgery.

How does VUR present?

Presentation varies by age: infants may have unexplained fever or poor growth, toddlers and older children often present with febrile UTIs, while some children and adults are asymptomatic and detected on imaging. Other signs include recurrent abdominal or flank pain and episodes of urinary tract infection resistant to treatment.

Key Investigations

We use targeted tests:
• Urine culture to confirm infection.
• Renal and bladder ultrasound to look for hydronephrosis or anatomical anomalies.
• MCU/VCUG (micturating cystourethrogram) to confirm and grade reflux.
• DMSA scan to detect renal scarring and assess cortical function when indicated.

Grading & Significance

VUR is graded I–V on MCU/VCUG. Low grades (I–II) often resolve spontaneously, especially in younger children, while higher grades (IV–V) have a greater risk of kidney damage and frequently require intervention.

Conservative Management

Suitable for many children with low-grade reflux: low-dose antibiotic prophylaxis to reduce febrile UTIs, parental education about hygiene, prompt treatment of infections, and scheduled follow-up imaging to watch for spontaneous resolution.

Minimally Invasive & Surgical Options

Endoscopic injection (STING) — quick, day-care procedure injecting a bulking agent below the ureteric orifice to stop reflux — is ideal for selected low–moderate grade cases. Surgical ureteric reimplantation (open, laparoscopic or robotic) is the definitive option for persistent high-grade reflux, recurrent febrile UTIs, renal scarring progression or failed endoscopic therapy.

Choosing the right treatment — what we consider

Our decision is personalised and depends on:

• VUR grade and laterality (single or both sides).
• Presence or progression of renal scarring on DMSA scan.
• Frequency and severity of febrile UTIs despite prophylaxis.
• Child's age and bladder-bowel function (constipation or dysfunctional voiding contributes to VUR).
• Family preferences after clear counselling on risks, benefits and follow-up expectations.

We emphasise kidney protection, minimising infections and choosing the least invasive effective option.

Procedure & Recovery: What families should know

Endoscopic injection (STING) — usually a short general anaesthesia, minimal pain, most children go home the same day and resume normal activity quickly. Follow-up imaging (ultrasound and sometimes MCU) is done to confirm success.

Ureteric reimplantation — performed under general anaesthesia. Open reimplantation may need a short hospital stay; laparoscopic or robotic approaches often reduce pain and hasten recovery. Catheter/stent care and postoperative instructions are provided; imaging and clinical checks follow to confirm resolution and kidney health.

Long-term outlook & kidney protection

With timely, appropriate management many children have good outcomes — infections reduce, reflux resolves or is corrected, and progressive kidney damage is avoided. Children with established renal scarring need long-term monitoring of blood pressure, renal function and growth with coordinated care from paediatricians and nephrologists where necessary.

Does VUR always need surgery?

No. Many children with low-grade VUR are safely managed conservatively with antibiotic prophylaxis and monitoring because spontaneous resolution is common. Surgery is reserved for persistent high-grade reflux, recurrent febrile UTIs, worsening scarring, or failed minimally invasive measures.

Is MCU/VCUG harmful for my child?

MCU/VCUG is a standard diagnostic test that uses small amounts of contrast and X-ray to detect reflux. When clinically indicated, the benefits of diagnosing and grading VUR outweigh the small radiation exposure. Modern protocols minimise radiation dose and ensure safety.

Can behavioural issues like constipation cause VUR?

Yes — dysfunctional voiding and constipation increase bladder pressure and UTIs and can worsen VUR. Managing bowel habits and bladder training are important parts of treatment and often improve outcomes.

How successful is endoscopic injection (STING)?

Success varies with VUR grade and technique; many children achieve resolution after a single injection while others may need repeat injection or definitive surgery. Your urologist will discuss likely outcomes based on your child's specific condition.

What follow-up will my child need after treatment?

Follow-up typically includes clinical reviews, ultrasound to assess kidneys and bladder, urine cultures as needed, and repeat MCU or DMSA scans based on initial severity and treatment. Long-term monitoring for blood pressure and renal function may be advised if scarring was present.

Should parents screen siblings?

Because of familial tendency, siblings — particularly young brothers and sisters — may be offered screening with ultrasound and, selectively, MCU after discussing risks and benefits with the clinician.

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Vesicoureteric Reflux (VUR) Treatment in Gomti Nagar Extension, Lucknow

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