Vesicoureteric reflux (grading)

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

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    Figure 1: normal - no reflux
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    Grade I (active) ...
    Case 1: grade 1
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     Figure 2: grade 1
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    Grade II vesicour...
    Case 2: grade 2
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    Figure 3: grade 2
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    Grade III (active...
    Case 3: grade 3 (active)
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     Figure 4: grade 3
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    Case 4: grade 3
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    Figure 5: grade 4
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    Grade IV (active)...
    Case 5: grade 4 (active)
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     Figure 6: grade 5
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    Case 6: grade 5
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