Dore B, Irani J, De Lustrac J M, Aubert J
Service d'Urologie, CHU de Poitiers.
J Urol (Paris). 1990;96(6):303-10.
On the basis of a series of 62 files gathered over 18 years, the authors study vesicorenal reflux in duplication of the ureters. The abnormally was bilateral in 10 cases, and a total of 206 ureters was analyzed. Clinically, fever and a urinary infection are the usual expression. While intravenous pyelography allows assessing the condition of the upper urinary tract, retrograde cystography demonstrates the reflux and indicates its degree. This study confirms that the reflux mainly occurs in the lower pelvis and that it is very marked (stage II + stage III = 62.9%). Three categories of patients should be distinguished: infants younger than age 2; children from age 2 to age 15; and adults. Purely medical treatment was disappointing, and surgery seems to by far the best solution. However, the solution is different according to whether or not another malformation is associated with duplication and reflux. In the latter case, the surgical procedure is simple, while in the former there often is a complex pathology which sometimes raises difficult surgical problems, especially in children.
