Urinary undiversion in young adults

Eighteen patients who underwent urinary diversion in childhood were undiverted. There were three main groups: the neurologically intact bladder, the neuropathic bladder and the "occult" neuropathic bladder. The simplest procedure of anastomosing the proximal ureters to the distal ureters was preferred. The neuropathic group required excision of the bladder remnant and substitution with detubularised bowel. In four patients the renal function was progressively deteriorating pre-operatively and two have required transplants. Renal failure in one of these patients was accelerated by a post-operative anastomotic stenosis and infection, although his early post-operative anastomotic stenosis and infection, although his early post-operative course was uneventful.