[Posterior XXXX . Type of treatment and short- and long-term evaluation of renal function].

@entity1 @entity340
In this paper the authors have analyzed the management and the outcome of 81 cases of @entity340 which occurred during the period January 1972 - April 1985. 53 @entity1 presented very severe @entity340 (grade 4 according to Hendren), 28 mild valve type. All the @entity1 of the first group but two had a dilatation of the U.U.T. Vesico-renal reflux, usually severe, was present in 51 ureters; in another 50 ureters a dilatation without reflux was present. 47% of the @entity1 of the first group had a renal function within the limits of normality at the moment of presentation and the remaining 53% a reduced renal function. In 9 @entity1 (8 under 50 days of age) a cutaneous vesicostomy according to Blocksom followed, at the age of 10-18 months, by transurethral valve destruction was done. In 6 @entity1 , in the early part of the series, the valve was removed with a hook via the perineal approach. In 38 @entity1 we performed a transurethral valve destruction with the n. 3 Bugbee electrode. 36 out of 53 @entity1 (68%) had exclusively a removal of the @entity340 . After the removal of the obstruction, 32 out of 37 non refluxing dilated ureters (86.5%) showed a clear improvement. In 7 out of 29 refluxing ureters a nephrectomy was carried out. In the remaining 22 ureters the reflux vanished in 17 and improved in the other 5. 17 @entity1 had other types of operations after valvular removal. 23 ureters in 13 @entity1 were reimplanted, with 3 failures (13%). In the 53 @entity1 with very severe valve (grade 4) supravesical diversions were not carried out. In the follow-up of 51 @entity1 (from 6 month to about 14 years) the renal function was within the limits of normality in 74% (before the operation it was 47%). The best results were obtained in @entity1 diagnosed and treated in the first months of life. Cutaneous vesicostomy showed itself to be a very useful method of treatment in very young babies with severe complications. We observed a slight terminal urethral stricture, easily dilatable, in only 1 @entity1 . All the @entity1 over the age of 12-13 years were continent. In 28 @entity1 with mild valves, as well as transurethral valve destruction, an ureteric reimplantation was carried out with success in 5 @entity1 (8 ureters) and a vesical diverticulectomy in another 2.
