Les auteurs insistent sur les points suivants: toute infection rebelle des urines chez l’enfant, toute protéinurie doit conduire à la pratique d’une urographie. Des anomalies mêmes légères de la morphologie des calices et de l’uretère pelvien doivent faire soupçonner un reflux, et demander une cystographie retrograde. La mise en evidence d’un reflux passif et mictionnel chez l’enfant doit faire poser une indication opératoire, à condition que le reflux persiste à 2 examens successifs et en dehors d’une cystite evolutive. Le traitement chirurgical du reflux doit être effectué si possible avant l’âge de 5 ans. La technique de Leadbetter leur donne toute satisfaction et elle leur paraît résoudre le problème technique du traitement des reflux vésico-urétéraux. II est inutile d’effectuer une operation anti-reflux chez un malade en état d’insuffisance rénale, avec une azotémie au-dessus de 1 g, et une clearance de Γurée au-dessous de 20 ml.

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© 1967 S. Karger AG, Basel
1967
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