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THE PREVENTION OF CHRONIC PYELONEPHRITIS 1,2
Author(s) -
J.Murphy John,
W.Schoenberg Harry,
A.Tristan Theodore
Publication year - 1965
Publication title -
british journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 0007-1331
DOI - 10.1111/j.1464-410x.1965.tb09574.x
Subject(s) - medicine , chronic pyelonephritis , vesicoureteral reflux , renal dysplasia , urinary system , reflux nephropathy , ureterocele , urology , cystometry , surgery , ureter , reflux , disease
SUMMARY There seems to be a definite relationship between urinary tract infection in childhood and chronic pyelonephritis in the adult. The infection may become established in the renal parenchyma of a child and become apparent only after puberty when it is recognised by a late sign such as uraemia, hypertension, or flare‐up of active infection during pregnancy. A survey utilising cinefluorographic voiding cysto‐urethrography and direct cystometry made on 186 children resulted in positive findings in 103. The majority of these children appeared to have a dysfunction of the bladder outlet similar to that not infrequently seen in the gastric pylorus, oesophagocardial junction and ureteropelvic junction. Correction of this defect by myotomy resulted in improvement in the clinical picture, bacteriological findings, cinefluorographic appearance of the outlet and voiding pressures in most of the children. Reimplantation of ureters which demonstrated vesicoureteral reflux was successful as determined by voiding cysto‐urethrography and bacteriological study. Prevention of chronic pyelonephritis can be best accomplished by a diligent search for the lesions predisposing to and facilitating infection in children and correction of these when they are found.