Pelviureteric obstruction in infancy and childhood. A review of 117 patients.

A series of 135 kidneys with pelviureteric obstruction in 117 children is reviewed (a 16% incidence of bilateral obstruction). The majority (89%) of pyeloplasties or other reconstructive procedures were performed via an anterior transperitoneal approach which afforded excellent surgical exposure with a low (4%) incidence of related post-operative complications. Extra-renal drainage alone was preferred to nephrostomy in the majority of patients. Children presenting with bilateral hydronephrosis were managed by a single, simultaneous bilateral procedure rather than by 2 operations. The total nephrectomy rate of 5% compares favourably with the results reported by authors who favour an extraperitoneal approach and routine nephrostomy drainage.