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Cutaneous vesicostomy was used for temporary urinary diversion in 12 infants with neurogenic vesical dysfunction. Hydronephrosis, azotemia and clinical urinary infection were resolved in all patients. Postoperative complications consisted of diaper dermatitis in 42 per cent and vesical prolapse in 25 per cent.

Our over-all results with intermittent clean catheterization in attaining continence and limiting the occurrence of significant infection while preserving renal function in children with neurologic bladder dysfunction have been gratifying and compare favorably to other series. The program has not only resulted in satisfactory continence in the majority but also it has been associated with marked improvements in personality, sociability and self-image in several of our older patients who are free from the odor, shame and discomfort of the incontinence for the first time in their lives. From our results and those of others it appears that intermittent clean catheterization is a safe, reversible and effective means of management of children with neurogenic bladders.

A case of ureteral obstruction from bypass surgery is presented with review of the literature. A pathogenesis for the obstruction has been suggested and specific treatment recommended. More importantly, however, a plea is made to place the ureter anterior to the graft and to study the patient both pre- and postoperatively to prevent obstruction of the ureter in these patients.