Unilateral vesicoureteral reflux and unilateral nonfunctioning kidney associated with posterior urethral valves--a syndrome?

From 1964 to 1982 we treated 8 patients with unilateral vesicoureteral reflux and posterior urethral valves. The majority of these ureters with reflux are associated with ipsilateral renal nonfunction and prompt upper tract decompression appears to salvage few such kidneys. Contralateral function has been excellent and the long-term prognosis appears good. Of the 8 patients 6 ultimately underwent nephrectomy. Surprisingly, there was no evidence for true dysplasia or significant inflammation in these specimens. The segmental changes were most consistent with an acquired process, secondary to reflux rather than primary dysplasia.