Vesicoureteral reflux in adult women with uncomplicated acute pyelonephritis

Abstract

OBJECTIVES: To evaluate the significance of vesicoureteral reflux (VUR) in adult women with uncomplicated acute pyelonephritis. METHODS: Eighty-six adult women with uncomplicated acute pyelonephritis were studied from April 1998 to October 2003. They showed no structural urinary tract abnormalities. The mean age of patients was 36.2 years (range, 19 to 54 years). We divided these patients into two groups. In group I (31 patients), we performed a voiding cystourethrogram (VCUG) on the third day of treatment to demonstrate possible transient low-grade VUR during the acute infectious phase. In group II (the remaining 55 patients), we performed VCUG after the seventh day of treatment. RESULTS: There were only 2 (2.3%) cases of VUR among 86 patients with uncomplicated acute pyelonephritis. No VUR was found in group I, and grade II reflux was found in 2 patients of group II. CONCLUSIONS: These results indicate that, unlike in children, VUR is not a significant factor causing ascending infection leading to the development of acute pyelonephritis in adult women. Further research is warranted regarding the pathophysiology of ascending infection in the adult population.