Use of ureter of nonfunctioning renal unit in pediatric urinary reconstruction

If following posterior urethral valve fulguration a unilateral nonfunctioning or poorly functioning kidney remains, nephroureterectomy is the customary method of management. The distal ureter of such renal units can serve as a means of salvage for complications resulting from surgery on the ureter serving the remaining solitary functioning renal unit. We present 2 cases of posterior urethral valves where planned preservation of the distal ureter of a nonfunctioning kidney allowed salvage of such complications. We advocate preserving the ureter of a nonfunctioning renal unit if possible until the fate of the solitary functioning kidney and ureter is clear. This approach can be applied to other aspects of pediatric urologic reconstructive surgery.