Testing for Vesicoureteral Reflux

The most common test for diagnosing VUR is a Voiding Cystourethrogram (VCUG). Other tests that may be performed include renal ultrasound, DMSA scan, Urodynamics (or video-urodynamics), MRI.

A VCUG can be a pretty scary and uncomfortable test for a child, but it is necessary in diagnosing reflux. The initial VCUG is done without sedation. Some doctors use another type VCUG, the nuclear VCUG, for follow-up testing. The nuclear VCUG is very sensitive in detecting reflux, but it cannot tell you what grade it is, only whether or not the reflux is still present which is why it is not used for initial diagnosis. During a VCUG, the child is catheterized, and a solution is injected into the bladder. This solution contains a contrasting material which will show up on the x-ray. After the solution is injected, they will take a series of pictures with an x-ray so that they can see if the contrast stays in the bladder or travels into the ureters or kidneys. If the contrast is seen moving upwards, VUR is present. Lizzie has had 2 VCUGs, and it is recommended that a child have one every 6 months to a year after being diagnosed with VUR. For more information on VCUG, please click here. This is a really good article on the test and what to expect.

Another test that is frequently done (many times before a VCUG) is a renal ultrasound. The ultrasound is not invasive and is a good tool for looking at the ureters, bladder and kidneys. During the ultrasound, they will look for any abnormalities in the kidneys, such as size and/or shape, and any abnormalities in the bladder, such as enlargement or obstruction. For more details on renal ultrasound, click here.

A DMSA scan is done to evaluate the kidneys, how well they are functioning (individually) and if there is any scarring or damage to the kidneys. It will also show if there are any obstructions. The DMSA scan will show how each kidney is functioning individually. Click here for DMSA, and here for Mag 3 (which I believe this is the same type of test using a different injection material).

A urodynamics test is a little more complex test, and is a good diagnostic test when there are complications. The test itself is done in a similar way to the VCUG, in that the child is catheterized, and a solution is injected into the bladder. During a urodynamics study they monitor the pressures in the bladder, and look to see how the bladder is working. It will show any abnormalities in the bladder, and will measure bladder capacity. In Lizzie's case, we did the urodynamics to see if there was a voiding dysfunction that could actually be causing her reflux. For more information on the urodynamics test, please click here.

An MRI might be done when it is suspected that a neurological problem could be causing the reflux. In rare cases, bladder dysfunction and VUR can be caused when there has been damage to the nerves in the spinal cord. This can be due to Spina Bifida Occulta, Lesions on the spinal cord, or trauma to the spine. This test is used to find any defects or abnormalities in the spine. An MRI in young children is usually done under general anesthesia. For more information on MRI please click here.

Next... Treatment of Vesicoureteral Reflux

Vesicoureteral Reflux, Symptoms of Reflux, Grades of Reflux, Testing for Reflux, Treatment for Reflux

The information on this web site should not be taken as medical advice, and you should contact your health care provider with any questions regarding your child's condition/health. The information on this site comes from the personal experience and opinions of parents, and does not come from doctors or medical experts, and should be taken as such.