[First-line vesico-psoas hitch ureteroneocystostomy for primary obstructive megaureter]

Between 1989 and 1997, 23 children with primary obstructive megaureter underwent surgical repair, routinely using a vesico-psoas hitch ureteroneocystostomy. Ten of them had a antenatal diagnosis. Mean postoperative follow-up was 3 years. No postoperative obstruction and no vesicoureteric reflux occurred. Assessment of renal function on the operated side showed improvement in 7 cases and stabilization in all other cases. No bladder dysfunction was observed. Vesicopsoas hitch is an advantageous procedure in this indication. It is almost always unnecessary to perform ureteral tailoring and its specific complications can be avoided. Psoas hitch is easily performed in infants and young children and this technique is particularly appropriate in the subgroup of patients with antenatal diagnosis.