Easy method of upper-pole heminephroureterectomy in duplex systems in children

An easy method of upper-pole heminephroureterectomy is described in which a finger is inserted into the dilated upper collecting system, and the upper pole is removed by dissecting directly against the collecting system using finger guidance. This approach prevents entry into the lower-pole collecting system, minimizes blood loss, and maximizes preservation of normal renal tissue. Easy access to the lower ureter through the same incision is facilitated by the use of the Sims vaginal retractor.