International Study Classification for Vesicoureteral Reflux

The International Reflux Study Committee proposed a classification scheme for grading the severity of vesicoureteral reflux.

Imaging studies:

(1) These are not described in the paper.

(2) Higher grades could be defined by several imaging techniques, including intravenous pyelograms.

(3) Grades I and II need to demonstrate reflux from the bladder into the ureters.

Findings	Grade
reflux into ureter only	I
reflux into ureter, pelvis and calices no dilatation of caliceal fornices	II
mild or moderate dilatation and/or tortuosity of ureter mild or moderate dilatation of renal pelvis no or slight blunting of fornices	III
moderate dilatation and/or tortuosity of ureter moderate dilatation of renal pelvis and calices complete obliteration of the sharp angle of the fornices, but maintenance of the papillary impressions in the majority of calices	IV
gross dilatation and tortuosity of ureter gross dilatation of renal pelvis and calices papillary impressions no longer visible in the majority of calices	V

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