Undiversion: When and How?

Abstract

The reason for the permanant diversion in the first place should be ascertained and that decision critically reevaluated. A careful estimation of renal function and renal reserve is of primary importance. Unless renal function is nearly normal in the child, serious consideration of undiversion is deferred until nearly full growth is achieved or until a clear record of improvement in renal function, despite increasing body mass, is established. When possible it is preferrable to reconstitute the urinary tract without using bowel segments, avoiding the attendant problems of mucous formation and electrolyte reabsorption.