STING for vesicoureteral reflux

Vesicouretal reflux (VUR) is the retrograde flow of urine from the bladder into the upper urinary system. It affects 1% of boys and girls. The ureterovesical junction is compromised by short submucosal ureteral length, insufficient detrusor backing to the ureter, and/or periureteral diverticuli. Vesicoureteral reflux is present in 29% to 70% of children with urinary infections^1,2 and is typically diagnosed by contrast voiding cystourethrogram or nuclear cystogram. The association among VUR, urinary tract infections (UTIs), and renal scarring has been noted for years. The overall goal of managing the child with UTIs is to prevent renal scarring, hypertension, or chronic renal failure. In fact, 3% to 25% of children with end-stage renal disease lost their renal function because of reflux nephropathy.^2,3 Renal scarring is detected best by DMSA scanning. However, some of the radiologically detected changes are congenital in nature and not acquired from postnatal UTIs (males > females).^4,5