LETTERS TO T H E E D I T O R
VESICOURETERAL REFLUX IN CHILDREN
COMMUNICATION WITH "ORGANIZED UROLOGY"
To the Editor: The article on "Vesieoureteral Reflux in Children: Indications for surgical and Nonsurgical Treatment," by P. C. Devine, M.D.; C. S. Davis, Jr., M.D.; C. J. Devine, Jr., M.D.; and J. G. Fiveash, Jr., M.D., in the March issue (vol. 3, page 315) of UROLOGY, was read with interest. I would like to congratulate the authors for their cystoseopic operative record sheet. Unfortunately, the authors have omitted some essential information; namely, whether the patients were infected or uninfected at the time of cystography. Comparisons among published series and the true incidence of children with reflux who require surgery can only be made when eystography is standardized. In the presence of acute inflammation, the incidence of vesicoureteral reflux increases, thus the percentage of children with reflux ultimately requiring surgery decreases. I would suggest that cystography and eystoscopy be delayed for four to six weeks following an acute episode of urinary infection. We could thus gather more meaningful statistics in the future. When infection is difficult to control, investigations have to be performed before sterilizing the urine. Such cases should be listed separately for comparative purposes.
To the Editor: It is good to have a new journal available, especially one that seems to be responsiv e to the interests and needs of those in the urologic field. I enjoy getting the journal. I have found most oi the articles of interest. I especially like the special section. The reason for writing this letter is that after having attended several meetings recently, it has become apparent that "'organized urology" does not have a forum where ideas can be communicated among physicians by letters. At this point, what I would be interested in is whether or not a system can be set up for publishing letters to the editor. These letters: would not necessarily be related to anything contained within the journal or in the past issues, but would serve as an open forum whereby physicians can communicate with "organized urology." It has become apparent to me in speaking with younger physicians that there is a great need for such a forum. I think it would do a lot of good. I would appreciate hearing your comments.
George T. Klauber, M.D. Assistant Professor Surgery (Urology), University of Connecticut, 181 E. Cedar Street, Newington, Connecticut 06111
C. K. Wanebo, M.D. 2323 North Seventh Building B Grand Junction, Colorado 81501 EDITOR'S NOTE: UROLOGY wishes to encourage letters expressing views on socioeconomic and other matters affecting "organized medicine," especially urologists.
In response to inquiries from contributors, UROLOGY is being received by the Library of Congre the National Library of Medicine and articles are indexed in the Index Medicus.
UROLOGY / MAY1974 / VOLUMEIII, NUMI3E!a5