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Vesicoureteral Reflux and Pyelonephritis

Richard G. Middleton, MD
JAMA. 1973;225(6):641. doi:10.1001/jama.1973.03220330053032.
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The late Dr. John A. Hutch was not the first to discover vesicoureteral reflux, but he is responsible, more than any one man, for the modern-day urologist's recognition that vesicoureteral reflux is pathological, that it renders the urinary tract vulnerable to repeated infections, and that it is a common cause of recurring pyelonephritis and renal damage. Hutch virtually insisted that urologists pay attention to this common and significant abnormality, and he devised the first antireflux operation.

This small volume is a very wellwritten review of vesicoureteral reflux with abundant and excellent illustrations and a fine list of references. The material, though already familiar to urologists who have followed Hutch's many articles on reflux, is brought together by the authors in a highly readable and comprehensive form. Following a historical account, the anatomy and physiology of the normal and the abnormal ureterovesical junction are described. Diagnostic methods are discussed, with the


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