EPIDEMIOLOGIC studies of healthy children for urinary tract disease have been few and have concerned themselves primarily with bacteriuria.1 The limitations of bacteriuria as the sole sign of uropathy become apparent when one considers the intermittent nature of urinary tract infection,2-5 the wide use of antibiotics, many of which temporarily sterilize the urine,3,6 and the frequent occurrence of uropathy without persistent infection of the urine.7 Additional practical screening procedures are needed.
Obstruction to the flow of urine is the major predisposing factor in the pathogenesis of pyelonephritis.8,9 Urogenital anomalies present in a significant segment of the pediatric age group10 are usually of an obstructive nature and often exert their influence in the early months of life.8,11-13 Significant obstruction of the lower urinary tract may be expected to be productive of symptoms or signs or both which, if the patient were carefully and systematically
RANDOLPH MF, GREENFIELD M. Lower Urinary Tract Obstruction in Normal Male Children: Early Detection by Urinary Diary. Am J Dis Child. 1965;110(5):523–530. doi:10.1001/archpedi.1965.02090030547006
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