February 1970


Author Affiliations

Rochester, Minn

Am J Dis Child. 1970;119(2):191. doi:10.1001/archpedi.1970.02100050193026

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REPLY BY AUTHORS  To the Editor.—We thank Drs. Perlmutter and Retik for their comments regarding our paper on the prune-belly syndrome. We, too, recognize the wide spectrum of abnormality regarding kidneys, ureters, and bladder. In our paper we did not elaborate on specific variations but we stated that approximately 50% of children with this abnormality died before they were 2 years of age.We are, however, obliged to disagree with Drs. Perlmutter and Retik regarding their opinion of vesicostomy or supravesical urinary diversion for "functional obstruction" of the urinary tract. We believe that if no anatomic obstruction exists and if infection is absent or if present it can be adequately controlled by medication; urosurgical procedures usually have nothing additional to offer in the management of these patients. I am sure urologic surgeons as well as pediatricians are aware of the added risk imposed by any urinary diversion procedure. It

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