[Children with posterior urethral valves, dilatation of both ureters and chronic kidney insufficiency. A retrospective analysis of effectiveness and risk of operative measures].

In all 16 boys with posterior urethral obstruction, bilateral ureteral dilatation and chronic renal failure (serum creatinine above 2 mg/dl), who were seen during the last 12 years in our departments, data about time and outcome of urological therapeutic interventions (nephrectomy, relief of bladder outflow obstruction and ureter reimplantation) were analysed retrospectively. In five patients surgical treatment was performed in our hospital, the other 11 children were referred from other hospitals. Nephrectomy of a small but not functionless kidney was performed in three of four patients without proper indication. Bladder outflow obstruction was relieved too late in five patients and insufficiently in four. 36 ureter reimplantations were performed on 24 ureters in 14 patients; reimplantation was unsuccessful in 26 ureters (72%) either because of postoperative reflux (11 ureters) or because of postoperative obstruction (15 ureters). In our opinion in boys with posterior urethral valves and bilateral ureteral dilatation ureter reimplantation should be limited to patients with proven obstruction at the uretero-vesical junction.