[Uretero-calicostomy for hydronephrosis caused by junction disease in children and adolescents. Apropos of 35 cases]

Abstract

35 children and adolescents were submitted to ureterocalicostomy for PUJ obstruction. The surgical procedure is explained and specially the importance of performing a regular, muco-mucosal anastomosis to avoid its secondary stenosis. 9 patients have an excellent result with absence of clinical symptoms, sterile urinalysis and normal IVP. 20 patients have a good result with absence of clinical symptoms, sterile urinalysis and improvement of the dilatation of the cavities. 2 secondary nephrectomies have had to be performed because of a dysplastic kidney (1 patient) or of a parenchymal infection (1 patient). 2 patients have no clinical symptoms but have no improvement of their IVP. 3 kinds of indications have been distinguished: failures of previous surgery of the PUJ (5 patients); PUJ obstruction associated with congenital kidney abnormalities as horseshoe kidney (15 patients) and malrotation (3 patients); severe PUJ obstructions with a very thin parenchyma (12 patients). Ureterocalicostomy appears to be a helpful procedure in some defined situations where a declive drainage of the urine essential. No late deteriorations have been recorded in this series.