Correlation of symptoms and results of direct bacterial localization in patients with urinary tract infections.

During the last 8 years we localized 725 urinary tract infections in 213 patients via the bladder washout test. With this test the infections were located in the upper urinary tract in 11.9 per cent of the patients without vesicoureteral reflux, 27.1 per cent with reflux and 25.3 per cent without reflux after a successful antireflux operation. Of all supravesical and vesical bacteriuric episodes 57.6 and 67.1 per cent, respectively, were asymptomatic. The presence of symptoms differed only slightly among patients with and without reflux, and with and without pyelonephritic scars. Vesical symptoms, such as dysuria and frequency, were seen in 18.8 per cent of the patients with supravesical and 26.2 per cent with vesical infections, while fever and/or loin pain occurred in 23.6 and 6.7 per cent, respectively. However, urinary tract infections with loin pain and/or fever were localized evenly between the bladder and upper urinary tract. We conclude that factors other than the site of infection determine the presence or absence of symptoms.