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Diagnosis of vesicoureteral reflux in children
Last reviewed: 06.07.2025

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Laboratory and instrumental diagnostics of vesicoureteral reflux
Inflammatory changes in the kidneys and urinary tract may be accompanied by isolated urinary syndrome, mainly leukocyturia. Proteinuria is more common in older children, and its occurrence in young children indicates gross renal changes against the background of vesicoureteral reflux.
The main method for diagnosing vesicoureteral reflux is micturition cystography, during which, depending on the degree of reflux of the radiocontrast agent, five degrees of vesicoureteral reflux are distinguished.
There are indirect signs of vesicoureteral reflux according to ultrasound data: scattered calyceal-pelvic complex, pyelectasis more than 5 mm, dilation of various parts of the ureter, uneven contours of the bladder, and defects in its filling.
When performing urography, the course of reflux can also be suspected by indirect signs: deformation of the renal pelvis cavity system; hypotension of the ureters and pelvises, deformation of the calyces; expansion and increased contrast of the lower third of the ureter; hydronephrosis; "silent" kidney; cicatricial changes in the kidneys.
Radioisotope renoscintiography shows a violation of the excretory function of the kidneys, defects of one of the segments. With late diagnosis of reflux, irreversible changes in the upper urinary tract and the following complications are observed: "functional obstruction" in the area of vesicoureteral reflux; overstretching of the upper urinary tract with the formation of urethrohydronephrosis, the degree of which depends on the volume of reflux; formation of reflux nephropathy.
Thus, the following clinical manifestations allow us to identify a "risk group" for the presence of vesicoureteral reflux: repeated bladder dysfunction, especially if combined with changes in urine tests, primarily leukocyturia; unreasonable repeated increases in temperature; abdominal pain, especially associated with urination.