Anatomy and function of the ureterovesical opening is briefly described and an etiological classification of vesico-ureteral reflux (VUR) given. The author describes clinical aspects of the reflux and its role in the pathogenesis of pyelonephritis, its course and its action on the upper urinary tract. Animal experimentation was carried out to see if it were possible to cause VUR by bladder inflammation and by what mechanism, and, further, the effect of the vesical inflammation on the upper urinary passages and the role of the VUR in it. In Experiment I bladder infection was caused by insertion of a piece of plastic with simultaneous introduction of bacteria. Experiment II was a repetition of the experiments of Auer and Seager. Here, artificial edema produced a VUR. Experiment III included infiltration of the posterior bladder wall with bacteria to produce severe vesical and ureteral inflammation. Based on these experiments, the author came to the following conclusions: 1. Acute bladder inflammation does not produce VUR if the vesicoureteral valve is normal. 2. The experiments of Auer and Seager are unsuitable models for the ‘inflammatory’ reflux. 3. A well closing ureterovesical valve protects against ascending bacterial movement. 4. If there is a VUR and simultaneous bladder infection, ascending infection practically always results. 5. If inflammation has progressed to the lower ureter, ascending infection follows even without VUR. 6. Since inflammation does not make a normal valve insufficient and most adult sufferers with pyelonephritis do not show VUR, it must be assumed that their renal malady came about in other fashion.

Keywords:
Cystitis, Miction cystography, Pyelonephritis, Reflux, vesico-urethral, Reflux, experimental, Reflux, classification, Ureteritis
This content is only available via PDF.
© 1971 S. Karger AG, Basel
1971
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.