Vesico-ureteral reflux and the adult male.

Abstract

SUMMARY 1 Seventeen adult males with reflux, ranging in age from 21 to 75 years, are presented. Those patients with reflux secondary to neurogenic bladder or after partial cystectomy are excluded. 2 The etiological factors associated with reflux may be congenital as well as acquired. 3 In males under 45, reflux is usually due to lower urinary tract obstruction associated with chronic cystitis. The obstruction may be congenital and of such a low-grade nature that only when associated with a secondary infection does the condition become evident. Operative repair for reflux in association with a revision of the bladder neck is the recommended form of treatment. 4 In patients with reflux due to prostatic obstruction or after iatrogenic injury of the intramural ureter, in whom reflux persists despite elimination of obstruction, conservative therapy should be initially attempted. An anti-reflux procedure is indicated to prevent further deterioration of the kidney if continued renal destruction occurs.