Long-term effects of urinary tract infections. The need for a controlled trial

Two series of children with urinary tract infections are compared: in one the infections were primarily covert, while in the other they were predominantly overt. Grade III reflux occurred only in the overt infection group, and the development or progression of renal clubbing and scarring was much more common in these patients. Now that effective, long-term prophylactic therapy for infection is available, the author urges that controlled trials be established to determine whether or not sterile reflux is harmful and whether or not ureteral reimplantation for reflux is of value.