Ureteric reflux and kidney scarring in children.

Vesico-ureteric reflux is commonly found in children who are investigated because of urinary tract infection. By allowing back-flow of infected urine from bladder into ureter, reflux may cause progressive damage to the upper urinary tract, such as dilatation of the ureter and scarring in the kidney. Hodson and Edwards (1960) noted that reflux was often associated with kidney scarring, and McGovern, Marshall, and Paquin (1960) made the striking statement that 'all upper urinary tracts with reflux are dying but at different rates'. Yet not everyone is convinced that the operative treatment of reflux is necessary. The occasional spontaneous disappearance of reflux when infection is controlled, and the markedly decreased incidence in adolescents and adults led Baker et al. (1966) to 'question whether the majority of children with reflux are not surgically overtreated'.