Editing Pediatrics: Vesicoureteral Reflux (section)

== Grading VUR ==

* The International Classification System, devised in 1981 by the International Reflux Study, is the current standard for grading reflux on the basis of the appearance of contrast in the ureter and upper collecting system during voiding cystourethrography.
* '''<span style="color:#ff0000">Grade I: reflux limited to the ureter'''
* '''<span style="color:#ff0000">Grade II: reflux up to the renal pelvis'''
* '''<span style="color:#ff0000">Grade III: mild dilatation of ureter and pelvicalyceal system'''
* '''<span style="color:#ff0000">Grade IV:'''
** '''<span style="color:#ff0000">Tortuous ureter with moderate dilatation'''
** '''<span style="color:#ff0000">Blunting of fornices but preserved papillary impressions'''
* '''<span style="color:#ff0000">Grade V:'''
** '''<span style="color:#ff0000">Tortuous ureter with severe dilatation of ureter and pelvicalyceal system'''
** '''<span style="color:#ff0000">Loss of fornices and papillary impressions'''
** Insert figure

* Accurate grading is impossible with coexistent ipsilateral obstruction.
* '''Grade of reflux positively correlated with risk of (2):'''
*# '''Renal nuclear scan abnormalities'''
*# '''Pyelonephritis'''