UroToday.com - A review by Dr. J. Christopher Austin showed that vesicoureteral reflux after puberty is not well documented but that those adolescents should be treated when recurrent pyelonephritis is present.

He reviewed ureteral reimplantation, endoscopic injections, and laparoscopic or robotic ureteral reimplantation in the armamentarium. He promotes endoscopic injection as "an appealing option for these patients". Other minimally invasive modalities will evolve in these patients as this disease is more readily diagnosed and treated.

Personally, I have a unique experience where teenagers and post teen women with a known history of reflux have issues regarding pyelonephritis. The majority of women presented with a history of pyelonephritis during pregnancy resulting in what was thought to be the reason for either a miscarriage or fetal demise…