BLADDER REFLUX

Abstract

Under normal conditions, the backflow of bladder contents into the upper urinary tract is prevented by a mechanism at the ureterovesical junction which acts like a sphincter. When, as the result of congenital or acquired conditions, this mechanism fails to act, urine from the bladder flows back (reflux) into the ureter and renal pelvis. A recent case has impressed on us the necessity of keeping in mind the possibility of such a reflux in cases of severe renal infection: A man, aged 50, was referred, on account of a marked urosepsis, by Dr. Vance Rawson. In addition to the history of a spinal syphilis of ten years' standing, complete retention of urine had existed for several weeks. No relief of the infection being obtained from an indwelling catheter, it was deemed advisable to ascertain whether some form of mechanical obstruction at the vesical neck was present. Cystoscopy revealed only marked