Two-stage procedure for the management of massive hydronephrosis

A case of congenital unilateral massive hydronephrosis containing 42.5 l. clear urine is reported. Treatment consisted of a 2-stage procedure that is described. The consequences of sudden decompression, which occurs after a 1-stage operation, are discussed. The rationale of the 2-stage procedure is that gradual decompression helps to restore the normal anatomical and physiological base lines so that the definitive operation of removal of the sac can be accomplished with minimum risk to the patient. This 2-stage technique is a relatively safe procedure based on sound principles.