[Exceptions to the rule concerning conservative treatment of polycystic renal dysplasia in children].

The authors report three cases of antenatally diagnosed polycystic renal dysplasia (PRD) associated with homolateral anomalies of the ureter and vas deferens requiring surgical exploration. The antenatal and postnatal diagnosis of polycystic renal dysplasia is based on ultrasound. It is recommended to look for associated vesicoureteric reflux by retrograde cystography. Conservative management is advised due to the natural involution of PRD. The authors emphasize the need for a more detailed ultrasound analysis of the lower genitourinary tract during the antenatal and postnatal period in order to identify an abnormal ureteric orifice, constituting the cause of the dysplasia. As dysplasia is predominant and the only anomaly detected on the antenatal examination, the associated lower tract anomalies will probably only be identified at birth. A better understanding and neonatal detection of associated lower urinary tract malformations probably justify a review of the current, systematic conservative approach, in a certain number of cases.