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[Occult reflux (author's transl)].

M W Köllermann, H Scherf, R Busch

    Der Urologe. Ausg. A
    |January 1, 1978
    PubMed
    Summary
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    Occult reflux, often undetected, leads to bladder bacteriuria in 80% of patients. This condition can cause upper tract infections, making surgical intervention a debatable treatment option.

    Area of Science:

    • Urology
    • Pediatric Nephrology
    • Infectious Diseases

    Background:

    • Vesicoureteral reflux (VUR) is a common cause of urinary tract infections in children.
    • Diagnosing VUR often relies on imaging techniques that may miss subtle cases.

    Observation:

    • Patients without radiologically evident reflux frequently presented with bladder bacteriuria (80%) or supravesical bacteriuria (20%).
    • This subclinical bacteriuria, termed 'occult reflux,' was associated with reinfection.

    Findings:

    • Occult reflux can lead to upper urinary tract contamination, potentially causing pyelonephritis.
    • Bilateral antireflux surgery appears to resolve occult reflux in many cases, questioning its therapeutic necessity.

    Implications:

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    • Re-evaluating diagnostic criteria for VUR is necessary to identify occult reflux.
    • The efficacy and indications for antireflux surgery require further investigation, especially in cases of occult reflux.