In some of these children the respiratory problems due to urinary ascites or urinoma have been wrongly attributed to pulmonary hypoplasia caused by renal obstruction or hypoplasia. Because of the dramatic reversal of respiratory symptoms, immediate aspiration or drainage of urinomas is suggested. On the other hand, Rittenberg et al. 4 reported well-preserved renal function in three boys with localized urinomas. Our patients had urinomas in addition to VURD, and the beneficial effect of either could not be determined separately. However, it would appear that any factor that provides a release of intra-renal pressure would contribute to preservation of renal function.
Reflux occurs most commonly on the left side and the associated renal unit is dysplastic.
The other non-refluxing kidney typically exhibits good function. Bladder diverticulae may be congenital or acquired. Acquired diverticulae are secondary to either functional or anatomical outflow obstruction. They usually are multiple and small, and generally associated with bladder trabeculation. Congenital diverticula typically are few in number, and they are not associated with bladder outlet obstruction.