Therapeutic tactics in combined ipsilateral ureteral obstruction in children
36 children with combined unilateral ureteral obstruction were examined. Twenty seven of them were boys, 9 - girls. In 35 cases combined ureteropelvic junction (UPJ) and ureterovesical junction (UVJ) stenosis were revealed in ureter(s) of a single kidney. In 26 cases obstruction was on a left side, 7 - right side and 2 - bilateral. Eight children had other various obstructive mono-anomalies in contralateral ureter. Surgical correction was performed in all children. In 30 of them, correction was started with UPJ reconstruction and nephrostomy. Retrograde ureteropyelography was performed 30-40 days later through the nephrostomy to assess UPJ and UVJ patency before the ureteral reimplantation. In 5 children, ureteral reimplantation was performed as a first step with subsequent UPJ stenosis correction made after.Combined obstruction in the ureter of a duplex kidney is a very rare pathology. Two-month old child with obstructive megaureter in upper half of a duplex kidney and stenosis in both UPJ and UVJ was cured with a 2-step procedure: 1st step - heminephrectomy with UPJ correction and nephrostomy; 2nd step - reimplantation of the ureter of the lower half in 30 days.