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Vesicoureteric reflux (grading)

Dr Henry Knipe and Assoc Prof Frank Gaillard et al.

Vesicoureteric reflux (VUR) grading divides vesicoureteric reflux according to the height of reflux up the ureters and degree of dilatation of the ureters:

  • grade 1: reflux limited to the ureter
  • grade 2: reflux up to the renal pelvis
  • grade 3: mild dilatation of ureter and pelvicalyceal system
  • grade 4
    • tortuous ureter with moderate dilatation
    • blunting of fornices but preserved papillary impressions 
  • grade 5
    • tortuous ureter with severe dilatation of ureter and pelvicalyceal system
    • loss of fornices and papillary impressions 2 

It is important to note that each side may have a different grade of reflux. 

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Article information

rID: 2267
Synonyms or Alternate Spellings:
  • Vesicoureteric reflux (VUR) grading
  • VUR grading
  • Grading of vesicoureteric reflux
  • Radiographic grading of vesicoureteric reflux

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Cases and figures

  • Figure 1: normal - no reflux
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  • Case 1: grade 3
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  •  Figure 2: grade 1
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  • Case 2: grade 5
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  • Figure 3: grade 2
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  • Case 3: grade V due to posterior urethral valve
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  •  Figure 4: grade 3
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  • Figure 5: grade 4
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  •  Figure 6: grade 5
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