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Urinary reconstruction (rather than diversion) for continence in difficult pediatric urologic disorders.

Surgical reconstruction of the pediatric urinary tract for purposes of restoration of function is a complex and highly successful undertaking that holds the potential of dramatically enhancing a child's health and quality of life. Unfortunately, such reconstruction may carry with it adverse sequelae that may complicate subsequent therapy and may be difficult to reverse completely. Urinary tract function has several components, each of which are essential to ensure maximal renal preservation, freedom from clinically significant infection, and continence. Several surgical alternatives exist for each component. Representative alternatives and surgical judgment with respect to their application are reviewed.