Minimal surgical interference in the prune belly syndrome.

Twenty-seven cases of prune belly syndrome which were well in the neonatal period are reported. Eleven were seen in the first year of life and 16 presented later. The first line of treatment was to ensure proper bladder emptying, usually by urethrotomy. Thereafter a policy of minimal surgical interference was followed, operating only for proven obstruction and intractable infection. This policy appears justified as 10 of 11 early presenters have done well. In the late presenters it was accepted that some renal damage had already occurred; nonetheless, 11 of 16 cases have done well. The X-rays were reviewed and hitherto unreported medullary cysts were noted. No radiological signs were found that were of prognostic significance.