Johnston J H
Br J Urol. 1979 Apr;51(2):100-104. doi: 10.1111/j.1464-410x.1979.tb02840.x.
A retrospective review was undertaken of 66 boys with posterior urethral valves with regard to incidence and prognostic significance of vesicoureteric reflux. The results indicate that: Regardless of the age of the patient, the existence of bilateral reflux at the time of presentation implies a worse prognosis than does unilateral or no reflux. Reflux which does not stop spontaneously after the valves have been destroyed is generally associated with a functionless and often dysplastic kidney; surgical cure of such reflux is therefore pointless. Reflux stops spontaneously after valve ablation when the involved kidney possesses useful function; surgical cure of reflux is therefore unnecessary. In some cases, however, it remains possible that reflux may continue to damage the kidney during the interval between relief of the urethral obstruction and spontaneous cure of the reflux. Nevertheless, the grossly dilated refluxing ureter is poor surgical material and it is concluded that the best chance of preserving renal function in the majority of boys with urethral valves and reflux lies in endoscopic fulguration of the valves, controlling infection and awaiting spontaneous reflux cure.
对66例患有后尿道瓣膜的男孩进行了回顾性研究，以探讨膀胱输尿管反流的发生率及其预后意义。结果表明：无论患者年龄如何，就诊时存在双侧反流的预后比单侧反流或无反流者更差。瓣膜破坏后不能自行停止的反流通常与无功能且常发育异常的肾脏相关；因此，对这种反流进行手术治疗毫无意义。当受累肾脏具有有用功能时，瓣膜切除术后反流会自行停止；因此，无需对反流进行手术治疗。然而，在某些情况下，反流仍有可能在尿道梗阻解除至反流自行治愈的间隔期继续损害肾脏。尽管如此，严重扩张的反流输尿管手术效果不佳，得出的结论是，对于大多数患有尿道瓣膜和反流的男孩，保留肾功能的最佳机会在于内镜下电灼瓣膜、控制感染并等待反流自行治愈。
