[Problems of cystic uretero-pyelitis (author's transl)]

The authors report on a series of 7 new cases of cystic uretero-pyelitis (C.U.P.). An historical and pathogenic review of this anatamo-radiologic entity is presented. The conditions for discovery were: renal colic in 4 instances, discovery during surgery in association with a pyeo-ureteral junction syndrome in one instance, and a hematuria in three instances (1 being accompanied by renal colic). Age varied from 22 to 78 years, with an average age of 61 years. The distribution between the sexes was equal: 4 women and 3 men. Urinary infection was observed in cases (colibacilluria), whereas it was absent in 3 cases. If hematuria is present, one should, as a rule, look for a possible association with an ureteral or vesical tumor (1 case). The final diagnosis can be established only through histological examination (this was the case in only 3 of our patients), but when there is a suggestive radiologic image and a reassuring clinical picture, one can recommend a simple medical treatment (1 recovery) and propose a steady radiologic surveillance. In case of doubt or hematuria, it is preferable to advocate surgical investigation: 2 patients out of the 3 showing a hematuria, were operated on, the third having refused. In one case, hematuria was due only to cystic uretero-pyelitis, while the second was known to have a vesical tumor with C.U.P. The real danger, in presuming a cystic uretero-pyelitis, is the failure to recognize a ureteral papillomatosis, hence the necessity of radiologic surveillance. The authors did not note any serious bilateral form. The only bilateral involvement seen in the 7 cases was not accompanied by reanl deficiency.