Vesicoureteral reflux in the monkey: a review

Area of Science:

• Urology
• Pediatric Nephrology
• Comparative Anatomy

Background:

• Vesicoureteral reflux (VUR) is common in infants but rare in adult primates.
• This suggests significant maturation of the ureterovesical junction (UVJ) with age.
• Understanding UVJ competence is crucial for pediatric kidney health.

Purpose of the Study:

• To investigate the age-related changes in ureterovesical junction competence.
• To determine the conditions under which urinary tract infections (UTIs) lead to reflux.
• To assess the impact of different types of reflux on renal function.

Main Methods:

• Comparative analysis of reflux incidence in infant versus adult non-human primates.
• Assessment of UVJ function in relation to infection and obstruction.
• Evaluation of renal function in the presence of vesicoureteral and intrarenal reflux.

Main Results:

• Reflux is a frequent occurrence in infant primates but significantly less common in adults.
• Urinary tract infections precipitate reflux primarily when the ureterovesical junction exhibits marginal competence.
• Neither vesicoureteral reflux nor intrarenal reflux impacts renal function in the absence of infection or obstruction.

Conclusions:

• Maturation of the ureterovesical junction effectively prevents reflux in adult primates.
• The presence of infection alone is insufficient to cause reflux; compromised UVJ function is a prerequisite.
• Renal function remains unaffected by reflux if the urinary tract is free from infection and obstruction.