British Journal of Urology (1977), 49, 80
0
Suggested Project For Urological Research
Does Ureteric Reflux protect against Calculus Formation? Urinary tract stone is a frequent disease and has been the subject of numerous articles in the urological literature. The association of urinary calculi and infection is one of the axioms of urology. During the past 20 years vesical-ureteral reflux has been recognised as a frequent and significant urological disease entity as well: it too is frequently associated with infection. I have been struck by the infrequency with which I have seen these two conditions associated in my own experience. Indeed, little has appeared in the literature concerning the association of these two diseases. The obvious question, therefore, is “Is it possible that vesical-ureteric reflux confers protection against the formation of renal calculi?” Skinner and Goodwin (1975) and others have treated recurrent stone-formers by substitution of ileum for ureter. Conceivably the improvement that occurs is not merely the result of the larger calibre conduit but may be a function of the reflux that is usually engendered by these procedures. This question could be answered by a relatively simple project. A foreign body would be implanted into the renal pelvis of the experimental animal to provoke stone formation A piece of zinc would be suitable, or perhaps discs cut from a staghorn calculus; these, of course, must be sterilised, weighed, and made sufficiently large so as to ensure their reten-
tion in the renal pelvis. Then, after allowing time for the pyelotomies to heal, the ureteric vesical valve on one side would be rendered inoperative; in this way a single animal would have a built in control. Follow-up examination could be done radiographically and finally by comparing the weight of the implanted stones on the two sides. This relatively simple experiment with a small number of animals should suffice t o indicate whether further research in this direction is justified. Summary The infrequent association of reflux and kidney stone suggest the possibility that reflux may in some measure protect against stone formation. A simple animal experiment is proposed which should indicate whether this assumption is valid. DAVDH. Kumz, MD 8540 Sepulveda Boulevard, Los Angeles, California 90045
Reference SKINNER, D. G. and GOODWIN, W. E. (1975). Indications for the use of intestinal segments in management of nephrocalcinosis. Journal of Urology, 113, 436-442.
80
0
Suggested Project For Urological Research
Does Ureteric Reflux protect against Calculus Formation? Urinary tract stone is a frequent disease and has been the subject of numerous articles in the urological literature. The association of urinary calculi and infection is one of the axioms of urology. During the past 20 years vesical-ureteral reflux has been recognised as a frequent and significant urological disease entity as well: it too is frequently associated with infection. I have been struck by the infrequency with which I have seen these two conditions associated in my own experience. Indeed, little has appeared in the literature concerning the association of these two diseases. The obvious question, therefore, is “Is it possible that vesical-ureteric reflux confers protection against the formation of renal calculi?” Skinner and Goodwin (1975) and others have treated recurrent stone-formers by substitution of ileum for ureter. Conceivably the improvement that occurs is not merely the result of the larger calibre conduit but may be a function of the reflux that is usually engendered by these procedures. This question could be answered by a relatively simple project. A foreign body would be implanted into the renal pelvis of the experimental animal to provoke stone formation A piece of zinc would be suitable, or perhaps discs cut from a staghorn calculus; these, of course, must be sterilised, weighed, and made sufficiently large so as to ensure their reten-
tion in the renal pelvis. Then, after allowing time for the pyelotomies to heal, the ureteric vesical valve on one side would be rendered inoperative; in this way a single animal would have a built in control. Follow-up examination could be done radiographically and finally by comparing the weight of the implanted stones on the two sides. This relatively simple experiment with a small number of animals should suffice t o indicate whether further research in this direction is justified. Summary The infrequent association of reflux and kidney stone suggest the possibility that reflux may in some measure protect against stone formation. A simple animal experiment is proposed which should indicate whether this assumption is valid. DAVDH. Kumz, MD 8540 Sepulveda Boulevard, Los Angeles, California 90045
Reference SKINNER, D. G. and GOODWIN, W. E. (1975). Indications for the use of intestinal segments in management of nephrocalcinosis. Journal of Urology, 113, 436-442.
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