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April 1964

The Reflux Ureter: Does it Protect the Opposite Kidney From Excessive Bladder Pressures?

Author Affiliations

Stephen Fortunoff, MD, 99 Forest Ave, Glen Cove, NY

Am J Dis Child. 1964;107(4):393-397. doi:10.1001/archpedi.1964.02080060395011

In recent years, the problem of vesicoureteral reflux in children has received increasing attention from urologists. Newer and better diagnostic techniques have made the diagnosis evident, where before it might have been missed. Cinefluoroscopy, used alone and in conjunction with pressure flow techniques, has made it possible to diagnose transient and minimal reflux and also to evaluate reflux as to the intravesical pressure and volume at which it occurs.1 Better understanding of the physiology of the ureterovesical junction and of the bladder neck have led to the application of more successful surgical techniques to prevent reflux and to facilitate bladder emptying.

At the Squier Urological Clinic, every effort is made to treat vesicoureteral reflux by conservative means. The patients receive chemotherapy and periodic urethral dilatations. Older children, who can cooperate, are instructed to employ multiple gentle voidings to empty the bladder. This conservative treatment is pursued in the hope