Character of Urinary Tract Infections and Pyelonephritic Renal Scarring After Antireflux Surgery

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Abstract
Forty girls who had undergone antireflux surgery (the Politano-Leadbetter technique) were followed at the mean age of 5.2 yr until they reached a mean age of 9.5 yr. Each girl was matched with a control. The pairs were matched for age at the onset of urinary tract infections and time of operation or selection, number as well as grade (1-3) of severity of the preoperative episodes and grade (II-IV) of reflux. Followup time for each member of the pair was identical. Postoperatively, the incidence of pyelonephritic urinary tract infection episodes (grade 3) was significantly less (P < 0.01) among the operated than the nonoperated cases (9 vs. 29), while the number of symptomatic lower urinary tract infections (grade 2) was virtually the same (14-19) in both groups. The operated cases had more asymptomatic bacteriuria (26 vs. 12 episodes) so that the total numbers of episodes of bacteriuria (grades 1-3) were similar in both groups. Antireflux surgery did not prevent the progression of pyelonephritic renal scarring, which continued equally in operated and nonoperated cases.