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Recurrent symptoms of urinary tract infection in eight patients with refluxing ureteric stumps
R Persad1, S Kamineni, P D Mouriquand
1Department of Paediatric Urology, Addenbrooke's Hospital, Cambridge, UK.
Objectives:
To evaluate and discuss the recurrent symptoms presented by eight patients with refluxing ureteric stumps.
Patients And Methods:
Eight patients (three boys, five girls; mean age: 8 years, range 11 months-14 years) with refluxing ureteric stumps presented with recurrent urinary tract infections. Six developed symptoms mimicking pyelonephritis, even though the kidney had been partially [5] or totally [3] removed. The stump was removed in all patients.
Results:
The stumps that were excised measured between 5 and 10 cm in length and were always dilated and inflamed. The results of histological examination and follow-up are reported.
Conclusions:
A dual approach is recommended when complete excision of the kidney and ureter is required. Symptoms of pyelonephritis are not pathognomonic of parenchymal infection but reflect infection above the vesico-ureteric junction. The distinction between supra-junctional and infra-junctional urinary tract infections seems more appropriate and is discussed.
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