Abstract
Of 134 girls with demonstrable ureterovesical reflux, 61 (105 ureters) had the reflux surgically corrected with an overall surgical cure rate of 97 percent. In the remaining 73 children (112 ureters), the reflux was treated conservatively with medical management alone. During the follow-up period no significant differences were demonstrated in the overall incidence of urinary tract infection; two years following corrective operation or medical treatment more than 50 percent of both medically and surgically treated children were still experiencing infections. A pronounced decrease, however, occurred in the incidence of clinical pyelonephritis among the surgically treated group. Following correction of reflux, the incidence of pyelonephritis was similar in both medically and surgically treated cases and was approximately the same as that found in a comparable group of children without reflux.
In approximately two-thirds of refluxing renal units in which there was evidence of clubbing and scarring before medical or surgical therapy, deterioration progressed during the follow-up period. In most of these cases infection control was felt to be inadequate with episodes of clinical pyelonephritis occurring during the period of medical management, or, in the surgically treated group, occurring just before corrective operation and the scar appearing within two years after operation.
The majority of renal units in which calyceal clubbing and parenchymal scarring was present had the most severe grades of reflux.
Full text
PDF







Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bergström T., Lincoln K., Redin B., Winberg J. Studies of urinary tract infections in infancy and childhood. X. Short or long-term treatment in girls with first or second-time urinary tract infections uncomplicated by obstructive urological abnormalities. Acta Paediatr Scand. 1968 May;57(3):186–194. doi: 10.1111/j.1651-2227.1968.tb04677.x. [DOI] [PubMed] [Google Scholar]
- Fair W. R., Govan D. E., Friedland G. W., Filly R. A. Urinary tract infections in children. Part I-- Young girls with non-refluxing ureters. West J Med. 1974 Nov;121(5):366–373. [PMC free article] [PubMed] [Google Scholar]
- Filly R. A., Friedland G. W., Govan D. E., Fair W. R. Urinary tract infections in children. Part II--Roentgenologic aspects. West J Med. 1974 Nov;121(5):374–381. [PMC free article] [PubMed] [Google Scholar]
- Fritjofsson A., Sundin T. Studies of renal function in vesico-ureteric reflux. Br J Urol. 1966 Aug;38(4):445–452. doi: 10.1111/j.1464-410x.1966.tb09733.x. [DOI] [PubMed] [Google Scholar]
- Govan D. E., Palmer J. M. Urinary tract infection in children. The influence of successful antireflux operations in morbidity from infection. Pediatrics. 1969 Nov;44(5):677–684. [PubMed] [Google Scholar]
- HOWERTON L. W., LICH R., Jr The cause and correction of ureteral reflux. J Urol. 1963 May;89:672–675. doi: 10.1016/S0022-5347(17)64618-4. [DOI] [PubMed] [Google Scholar]
- HUTCH J. A. Ureteric advancement operation: anatomy, technique and early results. J Urol. 1963 Feb;89:180–184. doi: 10.1016/S0022-5347(17)64525-7. [DOI] [PubMed] [Google Scholar]
- Heale W. F., Weldon A. P., Hewstone A. S. Reflux nephropathy. Presentation of urinary infection in childhood. Med J Aust. 1973 Jun 9;1(23):1138–1140. [PubMed] [Google Scholar]
- KUNIN C. M., ZACHA E., PAQUIN A. J., Jr Urinary-tract infections in schoolchildren. I. Prevalence of bacteriuria and associated urologic findings. N Engl J Med. 1962 Jun 21;266:1287–1296. doi: 10.1056/NEJM196206212662501. [DOI] [PubMed] [Google Scholar]
- Kunin C. M. The natural history of recurrent bacteriuria in schoolgirls. N Engl J Med. 1970 Jun 25;282(26):1443–1448. doi: 10.1056/NEJM197006252822601. [DOI] [PubMed] [Google Scholar]
- LICH R., Jr, HOWERTON L. W., Jr, GOODE L. S., DAVIS L. A. THE URETEROVESICAL JUNCTION OF THE NEWBORN. J Urol. 1964 Nov;92:436–438. doi: 10.1016/s0022-5347(17)63982-x. [DOI] [PubMed] [Google Scholar]
- POLITANO V. A., LEADBETTER W. F. An operative technique for the correction of vesicoureteral reflux. J Urol. 1958 Jun;79(6):932–941. doi: 10.1016/S0022-5347(17)66369-9. [DOI] [PubMed] [Google Scholar]
- Penn I. A., Breidahl P. D. Ureteric reflux and renal damage. Aust N Z J Surg. 1967 Nov;37(2):163–168. doi: 10.1111/j.1445-2197.1967.tb04004.x. [DOI] [PubMed] [Google Scholar]
- Peters P. C., Johnson D. E., Jackson J. H., Jr The incidence of vesicoureteral reflux in the premature child. J Urol. 1967 Feb;97(2):259–260. doi: 10.1016/S0022-5347(17)63025-8. [DOI] [PubMed] [Google Scholar]
- Rolleston G. L., Shannon F. T., Utley W. L. Relationship of infantile vesicoureteric reflux to renal damage. Br Med J. 1970 Feb 21;1(5694):460–463. doi: 10.1136/bmj.1.5694.460. [DOI] [PMC free article] [PubMed] [Google Scholar]
- STEPHENS F. D., LENAGHAN D. The anatomical basis and dynamics of vesicoureteral reflux. J Urol. 1962 May;87:669–680. doi: 10.1016/S0022-5347(17)65025-0. [DOI] [PubMed] [Google Scholar]
- Savage D. C., Wilson M. I., McHardy M., Dewar D. A., Fee W. M. Covert bacteriuria of childhood. A clinical and epidemiological study. Arch Dis Child. 1973 Jan;48(1):8–20. doi: 10.1136/adc.48.1.8. [DOI] [PMC free article] [PubMed] [Google Scholar]
- TANAGHO E. A., PUGH R. C. The anatomy and function of the ureterovesical junction. Br J Urol. 1963 Jun;35:151–165. doi: 10.1111/j.1464-410x.1963.tb02610.x. [DOI] [PubMed] [Google Scholar]
- Uehling D. T. Effect of vesicoureteral reflux on concentrating ability. J Urol. 1971 Dec;106(6):947–950. doi: 10.1016/s0022-5347(17)61444-7. [DOI] [PubMed] [Google Scholar]
- WILLIAMS D. I., ECKSTEIN H. B. SURGICAL TREATMENT OF REFLUX IN CHILDREN. Br J Urol. 1965 Feb;37:13–24. doi: 10.1111/j.1464-410x.1965.tb09568.x. [DOI] [PubMed] [Google Scholar]
