[Primary uretero-vesical malposition without radiological reflux (author's transl)]

Amongst a series of 190 cases of unilateral vesico-ureteric reflux detected by cystography, 94 children had a contralateral malformation identical to that where there was radiological reflux. They underwent a bilateral anti-reflux operation which in the majority of cases prevented any recurrence of acute pyelonephritis. The authors add a series of 18 cases of children who had suffered from several episodes of acute pyelonephritis without it being possible to demonstrate the radiological existence of vesico-ureteric reflux and in whom there was no obstructive disorder or lithiasis of the upper urinary tract. Nine of these patients showed corticopapillary involvement (unilateral in 8, bilateral in 1) similar to that seen in children with cystographic reflux. All the children of the group had a malformation of uretero-vesical implantation similar to that seen in the other children with cystographic reflux. After antireflux surgery (unilateral in 3 cases and bilateral in 15), almost all the children were free of further episodes of acute pyelonephritis. In the opinion of the authors, these two series of surgical patients validate the individualisation of this special group of "reflucing uretero-vesical malpositions without radiological reflux".