Ureterocalicostomy: an alternative to nephrectomy.

Ureterocalicostomy is a procedure with limited indications but with important application in the infrequent patient in whom the more desirable methods of creating unobstructed ureteropelvic drainage cannot be used. Three children are described in whom successful ureterocalicostomy was performed. The most common condition in which ureterocalicostomy has been useful is in the obstructed and scarred, intrarenal pelvis in which a classic type of ureteropyelostomy is not possible. The most important technicalconsideration seems to be sufficient amputation of the lower pole renal cortex in order to free the ureterocaliceal anastomosis from the surrounding cortical tissue. The 3 cases illustrate the difficult situations in which ureterocalicostomy may be indicated and the value of this procedure in preserving maximal renal function in children.