Problems and solutions in surgical treatment of 100 consecutive ureteral duplications in children.

Surgical management of 100 children with abnormalities related to ureteral duplication is reviewed. In general, separation of the distal portions of the double ureters is avoided, at least during the initial procedure, because this maneuver represents a significant risk to the blood supply and hence to the integrity of the remaining ipsilateral ureter. Complete ureteral duplication with vesicoureteral reflux is best managed initially by reimplantation of the duplex unit. On the other hand, upper segment heminephrectomy with subtotal ureterectomy is the initial treatment of choice for ureters ending ectopically with or without ureterocele.