The results of management of primary functional obstructive megaureter are reported in 29 children with 35 obstructed renal units. Grade 1 dilatation was found in 5 renal units, grade 2 in 14 and grade 3 in 16. Grade 1 and uncomplicated grade 2 obstructions were treated expectantly. Surgery was necessary in one grade 1 obstruction deteriorating to grade 2 and in two cases grade 2 with persistent urinary tract infections and deteriorating renal scans. All grade 3 ureters were treated by surgery: in 14 cases reimplantation was combined with calibre reduction of the ureter. In a majority of the patients the results were good in all grades of obstruction and no failures were seen.

For the treatment of ureteroceles several surgical procedures have been described. The results of surgical treatment of 21 ureteroceles in 19 children treated with various types of surgery are reported. Reviewing these results and some recent papers in the literature one can say that in small intravesical ureteroceles the preferred surgical technique should be as simple as possible. A transurethral inferior osteotomy, transurethral puncture, or partial excision of the ureterocele with remodeling of the intravesical ureter should be the procedure of choice. In case of a large intravesical ureterocele with a single kidney, total excision of the ureterocele and reimplantation of the ureter into the bladder has been recommended. In ectopic ureteroceles and intravesical ureteroceles with a duplex system, heminephrectomy with partial ureterectomy can be performed, as in most cases the upper pole is nonfunctioning and dysplasic. Because of the various types of ureterocele and associated anomalies it is advisable to make an individual plan for surgical treatment for each patient.

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During the past two years 54 boys underwent a cordectomy in the Sophia Children's Hospital in Rotterdam. An operative procedure was followed which combined the advantages of the techniques described by Byars and Van der Meulen. This operative technique and the subsequent results are described.

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