Current Trends in Pediatric Urology

• Published in: Pediatrics (Evanston) 1977-12, Vol.60 (6), p.913-915
• Main Authors: Woodard, John R., Belman, A. Barry, Walker, R. Dixon, Kaplan, George W., Firlit, Casimir F.
• Format: Article
• Language: English
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.60.6.913

More than 40 papers were read before the Urology Section of the annual meeting of the American Academy of Pediatrics in Chicago, October 17 to 2i, 1976. Some of those papers were presented as parts of symposia currently important to both pediatricians and urologists. Three such symposia are summarized in this report. EFFECT OF VESICOURETERAL REFLUX ON THE KIDNEY Vesicoureteral reflux continues to be a controversial topic and one in which the parameters for management are being constantly reassessed. The Joint Action Committee on Vesicoureteral Reflux presented a panel discussion emphasizing the effects of reflux on the kidney. The most fundamental facts about reflux concern its relationship to bacteriuria and chronic renal scarring.1 While prevalence of bacteriuria in preschool girls is about 1%, in school-age girls it rises to about 2%. In these children the emergence rate of urinary tract infection is between 3% and 5%. Among girls found to have bacteriuria the prevalence of reflux is 20% to 30% with renal scarring being present in 15% to 20% of this group. These latter figures are considered to be conservative estimates. Actually, 90% of children with renal scarring demonstrate evidence of current or previous vesicoureteral reflux.2 The data of Winberg et al. indicate that the kidney is most vulnerable to scarring during the first year of life.3 In 1969 Hodson introduced the concept that intrarenal reflux may be the primary factor leading to renal scarring. In support of his concept Hodson et al. carried out extensive experimental studies in swine, an animal selected because of the similarities between the kidney of the pig and that of the humans.4