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The effects of chronic cystitis on vesicoureteral reflux in an animal model
Abstract:
The purpose of this study was to determine if chronic cystitis interferes with maturation of the ureterovesical junction, thus prolonging vesicoureteral reflux in infant rhesus monkeys (Macaca mulatta). Serial implantations of a Proteus-infested silastic pellet into the bladder wall ensured continued infection as demonstrated by urine culture. Chronic cystitis as evidenced by pathological findings at surgery and sacrifice was created in a group of infant monkeys who had initial spontaneous vesicoureteral reflux. There was no evidence of pyelonephritis. Four animals represent a short term study since they were followed from four months to one year of age. Three animals were long term studies and were evaluated for at least 21/2 years. In no animals did chronic cystitis delay the normal disappearance of vesicoureteral reflux that is commonly seen in these animals as the ureterovesical junction matures, as demonstrated by serial cystograms. In two animals reflux (after initial clearing) reappeared when a bladder calculus formed in these chronically infected animals. Renal damage occurred only in these animals. In conclusion, this animal model failed to demonstrate interference with normal vesicoureteral junction maturation in the face of a chronic bladder infection.
Insights
Chronic bladder infection did not impede ureterovesical junction maturation in infant rhesus monkeys. Vesicoureteral reflux resolved normally, though bladder stones caused recurrent reflux and kidney damage in some cases.
Area of Science:
- Pediatric Urology
- Infectious Diseases
- Primate Models
Background:
- Vesicoureteral reflux (VUR) is common in infants and typically resolves as the ureterovesical junction matures.
- Chronic bladder infections may potentially disrupt this normal maturation process.
Purpose of the Study:
- To investigate if chronic cystitis interferes with ureterovesical junction maturation.
- To determine if chronic bladder infection prolongs vesicoureteral reflux in infant rhesus monkeys.
Main Methods:
- Infant rhesus monkeys with spontaneous VUR were experimentally induced with chronic cystitis via Proteus-infested silastic pellets.
- Animals underwent serial cystograms to monitor VUR and were pathologically examined.
- Studies included short-term (4 months to 1 year) and long-term (at least 2.5 years) follow-up.
Main Results:
- Chronic cystitis did not prevent the normal resolution of VUR as the ureterovesical junction matured in any animal.
- Recurrent VUR was observed in two animals after initial resolution, coinciding with the formation of bladder calculi.
- Renal damage occurred exclusively in the animals that developed bladder calculi.
Conclusions:
- This animal model did not demonstrate that chronic bladder infection interferes with normal ureterovesical junction maturation.
- Bladder calculus formation in chronically infected bladders can lead to recurrent VUR and potential renal damage.