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To the Editor.—
The natural history of vesicoureteral reflux is still controversial. A case of probable primary reflux in a woman of 73 years showing remarkable roentgenographic changes without serious impairment of renal function is therefore of interest.The patient, a spinster, was referred by an internist because of pyuria and a history of intermittent cystitis for more than 20 years. She had consulted an internist because of an attack of acute diarrhea during which she had lost 20 lb. She had had occasional afebrile symptoms of lower urinary tract infection for about 20 years. Her general health had been excellent, she had never been pregnant, and her last menstrual period had been at about 50 years of age.Physical examination revealed post-menopausal atrophy of the vaginal mucosa and a large rectocele. The catheterized urine showed a trace of albumin, much pus, and many bacilli. After two-weeks treatment with sulfamethoxazole,
Oppenheimer R. Vesicoureteral Reflux. JAMA. 1971;217(5):695. doi:10.1001/jama.1971.03190050151018