The Occurrence and Significance of Vesico‐ureteral Reflux in Children

SUMMARY Four hundred and forty‐five children between 3 and 15 years of age have been examined by micturating cysto‐urethrography: 430 children had enuresis, ten urinary infection, and five had miscellaneous symptoms. A vesico‐ureteral reflux occurred in sixty‐one children. The relationship between reflux and obstructive abnormalities, reflux and non‐obstructive abnormalities, and reflux and infection has been studied. The findings indicate that lower urinary tract obstruction is not a common cause of vesico‐ureteral reflux in children and that other abnormalities, e.g ., wide bladder‐neck anomaly, are not commonly associated with vesico‐ureteral reflux. There was a high incidence of association between vesico‐ureteral reflux and megaureter particularly with pyelitis, but whether the infection was the cause of the reflux or vice versa was not clear. Fifteen children with reflux were examined in detail in the upright position and it was found that the reflux was not confined to any one stage of filling or emptying. The height of the reflux did not seem to depend on whether the patient was in the supine or vertical position. In this series, thirty children showed a vesico‐ureteral reflux without any other apparent abnormality of the urinary tract, i.e ., there was no evidence of obstructive uropathy. no evidence of neurogenic uropathy, e.g ., spina bifida with neurological signs, no history of previous urinary infection, and repeated examinations of urine were normal.