VUR · Rim

VUR Vesicoureteral reflux grading

vigente

Grades vesicoureteral reflux on voiding cystourethrography.

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Escala de categorias

I II III IV V

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Procedência e vigência

Órgão emissor: International Reflux Study Committee
Versão: 1985
Ano: 1985
Família: léxico
Tipo de lógica: flat
Modalidade: Fluoroscopy
Fonte primária: International system of radiographic grading of vesicoureteric reflux · doi:10.1007/BF02388714
Última verificação: 2026-06-26
Última checagem: 2026-06-26

Lógica de decisão

Forma estruturada (flat). Uma futura calculadora a lê; as categorias abaixo são a superfície legível.

Mostrar a lógica estruturada (JSON)

{
  "categories": [
    "I",
    "II",
    "III",
    "IV",
    "V"
  ]
}

Categorias num relance

Cat.	Significado	Conduta	Risco	Fonte
I	Grade I Reflux into a non-dilated ureter only (urine refluxes solely into the ureter, which is not dilated).	Lowest-risk grade: conservative observation with the goal of keeping urine sterile; continuous antibiotic prophylaxis individualized/selective (e.g. infants or recurrent febrile UTI) rather than routine, given high spontaneous-resolution rates.	High spontaneous resolution: about 75% (range 70-80%) of grade I-II VUR resolves spontaneously by age 5.	okfonte NBK563262 ('about 75% (70% to 80%) of children with grade I and II VUR will spontaneously resolve ... by age 5'); corroborated by en.wikipedia Vesicoureteral_reflux 'Severity'.
II	Grade II Reflux reaching the renal pelvis and calyces (ureter and pelvis) without dilatation.	Conservative/low-grade approach: observation with sterile-urine maintenance; antibiotic prophylaxis individualized rather than uniformly applied.	Favorable: about 75% (range 70-80%) of grade I-II VUR resolves spontaneously by age 5.	okfonte NBK563262 ('about 75% (70% to 80%) of children with grade I and II VUR will spontaneously resolve ... by age 5').
III	Grade III Mild-to-moderate dilatation of the ureter and pyelocalyceal system with only mild/minimal blunting of the calyceal fornices.	Lower end of 'high-grade': continuous antibiotic prophylaxis is generally recommended; endoscopic subureteric injection considered if intervention is needed and breakthrough infections occur.	Moderate resolution: grade III-IV resolves spontaneously in roughly 60-70% over 5 years when reflux is unilateral and detected before age 2.	okfonte NBK563262 (grade III = mildly dilated ureter/pelvocalyceal system, minimal calyceal blunting; 'for grades III and IV ... VUR will resolve in 60% to 70% over 5 years' if unilateral and found before age 2; prophylaxis, endoscopic injection).
IV	Grade IV Moderately tortuous, mildly-to-moderately dilated ureter with dilatation of the renal pelvis and calyces and blunting of the calyces, while the papillary impressions are still visible.	High-grade: antibiotic prophylaxis typically recommended; surgical correction (ureteral reimplantation, ~98-99% success) or endoscopic injection (~59% success) for recurrent/breakthrough infection or non-resolution.	Lower spontaneous resolution (grade III-IV ~60-70% over 5 years only if unilateral and detected before age 2); open/robotic reimplantation is highly successful (~98-99%), while endoscopic injection succeeds in ~59%.	okfonte NBK563262 (grade IV = tortuous moderately dilated ureter, calyceal blunting with preserved papillary impression; grade III-IV 60-70% over 5 yr if unilateral/early; reimplantation 98-99%, endoscopic grade IV 59%).
V	Grade V Severely (grossly) dilated, very tortuous ureter with marked pyelocalyceal dilatation and loss of the papillary impressions/fornices.	Highest-grade: surgical intervention (open ureteral reimplantation) is usually preferred; antibiotic prophylaxis for very young infants pending repair; endoscopic injection an alternative (~62% success).	Spontaneous resolution without surgery is rare; open/robotic reimplantation success is around 80% (lower than the 98-99% seen in lower grades), while endoscopic injection succeeds in ~62%.	okfonte NBK563262 (grade V = grossly dilated tortuous ureter, loss of papillary impressions; 'spontaneous resolution without surgical intervention is rare'; reimplantation ~80%, endoscopic 62%).

Histórico de versões

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