Vesicoureteral Reflux

Karl R. Herwig, MD
JAMA. 1972;221(7):714. doi:10.1001/jama.1972.03200200060024.
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To the Editor.—  The article by Schmidt, Hawtry, Flocks, and Culp "Vesicoureteral Reflux, An Inherited Lesion," (220:821, 1972) does not seem to clarify the already cloudy picture. The evidence presented to prove the hypothesis is tenuous and circumstantial. That the patients were related, had urinary tract infection, and vesicoureteral reflux raises the possibility that the vesicoureteral reflux could be inherited, but no further evidence is presented to substantiate the conclusion. From the evidence presented, one could also conclude that vesicoureteral reflux is secondary to urinary tract infection, since all patients were found to have their reflux after a urinary tract infection. In addition, using the same reasoning, one could make the conclusion that cigarette smoking is inherited.Before concluding that something is inherited, all possible factors must be considered. None of the patients had reflux discovered at birth but only after urinary tract infection. The observation that the vesicoureteral reflux


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