Surgical interventions on 368 pelviureteral segments were made in 348 hydronephrosis patients under 14 years old. Bilateral disease occurred in 20 patients. Resection of the pelviureteral segment was performed with ureteropyeloplasty according to Anderson-Hynes-Kucera procedure. Good results were observed in 97.82% of cases followed-up from 1 to 2 years after the operation. Histological examination of the resected segments revealed structural changes in the wall of prepelvic part of the ureter primarily of congenital genesis, irrespective of low-polar vessels, high origin of the ureter, its fixed kink or narrowing. Irreversibility of structural lesions necessitated conduction of resection ureteropyeloplasty with creation of morphofunctionally patent pelviureteral anastomosis. High efficacy of the operation supports its pathogenetic validity. The effect persisted at the follow-up. After operative correction of hydronephrosis medication should be aimed at adequate therapy of pyelonephritis and stabilization of sclerosis in renal parenchyma, at improvement of immune status and urodynamics. Further follow-up, control of the kidneys in search for advanced postobstruction treatment are needed.
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