Bilateral high loop ureterostomy in the primary management of posterior urethral valves in a developing country

Of 200 consecutive cases of posterior urethral valves (PUV) managed in a si ngle institution, 26 underwent bilateral high loop ureterostomy (BU) as the ir first operative intervention. Indications for BU were persistently raise d serum creatinine levels after bladder drainage, severe urosepsis, and uri nary ascites, especially in a neonate or infant. After a median period of 1 year of diversion, the serum creatinine fell from a median value of 2.5 to 0.6 mg%. Twelve cases have been fully undiverted without deleterious effec ts (median serum creatinine level 0.5 mg%). Three patients died. Of the 14 renal units with documented persistent vesicoureteric reflux at the time of undiversion, only 1 has been reimplanted. One child has undergone bladder augmentation.