Objective To assess the outcome of the distal ureteric stump (DUS) after (hemi)nephrectomy with subtotal ureterectomy. Patients and methods The records of 89 patients (median age 2.7 years, range 0.25±12) who underwent nephrectomy (24) or heminephrectomy (65) with subtotal ureterectomy between 1982 and 1996 were reviewed retrospectively for symptoms caused by the DUS. The mean follow-up was 9.8 years. Nephrectomy was undertaken for a poorly functioning dysplastic (in nine), scarred (in 10) or hydronephrotic (in ®ve) kidney, and heminephrectomy for a poorly functioning upper moiety associated with ectopic ureterocele (in 26) or stenotic hydroureter (in 15), or for a poorly functioning lower moiety associated with re¯ux (in 24). There were 38 re¯uxing and 51 non-re¯uxing ureteric stumps. Two additional patients primarily operated elsewhere were referred with DUS symptoms. Results Only one patient had a symptomatic DUS, with recurrent haematuria and bacteriuria. The two patients referred from elsewhere presented with febrile UTIs. The ®rst had been left with a long re¯uxing stump opening ectopically into the urethra, and the second with a long stump which was converted from nonre¯uxing to a re¯uxing stump when he developed dysfunctional voiding. Surgical excision of the distal stump was curative in each case. Conclusions The risk of a symptomatic DUS in patients who undergo subtotal ureterectomy in conjunction with (hemi)nephrectomy is very low, with no difference between re¯uxing and nonre¯uxing stumps. Long ureteric stumps and dysfunctional voiding may cause symptoms. Because of the low morbidity associated with a short ureteric stump, we recommend subtotal ureterectomy in children who undergo (hemi)nephrectomy for re¯ux, vesico-ureteric obstruction or ectopic ureterocele associated with a poorly functioning kidney or kidney moiety.

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OBJECTIVE To investigate serum prostate specific antigen (PSA) levels with age and sex in childhood. SUBJECTS AND METHODS This prospective study included 205 children (123 boys, 82 girls; mean age 59.27 months, sd 3.78, range 2 days to 204 months) with no urogenital or endocrine disorders. PSA levels were measured using a highly sensitive, ‘third‐generation’ PSA (time‐resolved immunofluorometric) assay, able to detect PSA levels of ≥ 1 ng/L (0.001 ng/mL). Children were divided into four groups by age, i.e. A (0–12 months; 34 boys/20 girls); B (13–48, 37/21); C (49–144, 41/32); and D (> 144, 11/9). The data were analysed statistically using analysis of variance. RESULTS An accurate measurement of PSA was possible in both sexes using the assay. The median (sd, range) PSA level in boys was 38.41 (1.318, 1–2768) ng/L, and in girls 4.059 (1.392, 1–287) ng/L. There were no significant differences between girls at all age groups, or between the sexes for groups A–C, but levels were significantly higher in boys in group D (30 times that in girls), at 142.59 (1.53) and 4.85 (1.58) ng/L (P < 0.01). CONCLUSIONS PSA levels do not differ significantly between boys and girls until 12 years old, after which there is a significant and steep increase in PSA in boys, reflecting the development of the prostate. Assessing PSA in children could be used as a potential marker in the diagnosis and follow‐up of urogenital disorders.

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