There is, at the present time, an interesting and persistent controversy between certain internists and certain urologists concerning the management of infections of the urinary tract. Before commenting on this controversy, it would be well to attempt to reach a clear understanding of the points at issue in the contention.
Urologists generally have concluded, from their observation of human patients, that obstruction to the urinary passages is the most important element favoring infection.
Laboratory investigators, whether they be urologists, internists, pathologists, bacteriologists or go by any other appelation, but working on animal subjects, have practically unanimously reached the same conclusion. The differences in concept spring from disagreement as to what constitutes obstruction. Twenty years ago one could say that obstruction was not demonstrated unless there was residual urine, marked difficulty in voiding, and roentgenographic showing of anatomical changes such as filling defects, trabeculation, cellules or diverticula of the bladder, hydroureter,
DAVIS DM. On Infections of the Urinary Tract: Communication to the Editor From a Urologist. Arch Intern Med. 1963;112(1):6–8. doi:10.1001/archinte.1963.03860010052003
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