Vesicoureteral reflux in the primate. IV: Infection as cause of prolonged high-grade reflux

High-grade reflux commonly lasts longer than moderate reflux, which disappears with maturation of the ureterovesical junction. It is known that ureteral function is affected by urinary tract infection from studies in experimental animals, as well as through clinical findings in patients with upper t...

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Bibliographic Details
Published in:Pediatrics (Evanston) 1988-07, Vol.82 (1), p.91-95
Main Authors: ROBERTS, J. A, BERNICE KAACK, M, MORVANT, A. B
Format: Article
Language:English
Subjects:
Animals
Biological and medical sciences
Dilatation, Pathologic
Escherichia coli Infections
Female
Humans
Kidney - pathology
Macaca fascicularis
Macaca mulatta
Male
Medical sciences
Nephrology. Urinary tract diseases
Pyelonephritis - etiology
Pyelonephritis - pathology
Time Factors
Ureter - pathology
Urinary Bladder Neck Obstruction - surgery
Urinary system involvement in other diseases. Miscellaneous
Urinary Tract Infections - etiology
Urinary tract. Prostate gland
Vesico-Ureteral Reflux - etiology
Vesico-Ureteral Reflux - pathology
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Summary:High-grade reflux commonly lasts longer than moderate reflux, which disappears with maturation of the ureterovesical junction. It is known that ureteral function is affected by urinary tract infection from studies in experimental animals, as well as through clinical findings in patients with upper tract infection. Whether infection might affect the ability of the ureter to prolong high-grade reflux was questioned. This observation might explain why high-grade reflux does not disappear as rapidly as moderate reflux in children with recurrent urinary tract infections. Vesicoureteral reflux was produced surgically in combination with bladder neck obstruction using infant monkeys. The reflux thus produced was high grade with ureteral dilation and caliectasis. In the group of animals in which the bladder neck obstruction was relieved surgically, the reflux rapidly disappeared. In the other group, a bladder infection was produced with Escherichia coli at the time of release of the bladder neck obstruction. The reflux lasted significantly longer, an average of 18 months. Therefore, it appears that treatment of urinary tract infection rather than vesicoureteral reflux is the most important therapy.
ISSN:0031-4005
1098-4275
DOI:10.1542/peds.82.1.91