Inflammatory cell infiltrate in distal ureteral segments from patients with reflux

A total of 110 reimplanted ureters from 61 patients were examined by light microscopy. Twenty-four distal segments from nonrefluxing ureters were used as control group. Overall, 55 of 110 specimens (50%) had inflammatory cell infiltrates (ICI) consisting of lymphocytes and plasma cells in the submucosa and adjacent muscularis. Forty-five ureters (82%) had mild ICI, and 10 ureters (18%) had moderate or severe ICI only in patients with history of infection. ICI increased with grade of reflux in both infected and noninfected groups. Of 75 ureters (68%) from patients with history of infection, 45 (60%) had ICI. Ten of 35 ureters (29%) from patients without history of infection had ICI. A causal relationship between reflux and ICI remains speculative and needs further study.