Forty-seven cases of prune belly syndrome in children born between 1948 and 1977 are described. They have been classified into three groups according to the state of the urinary tract in the neonatal period. The results achieved in these cases form the basis of our present management. In group I, the most severely affected, early death is inevitable. In group 2 the children are ill as neonates; high diversion is often required and later reconstruction may be possible. Group 3 patients are healthy as neonates and little reconstructive surgery is required. The prognosis in groups 2 and 3 is good. Half the group 2 children and three-quarters of the group 3 children grew up normally with satisfactory renal function and health. It is important to establish free drainage of the urinary tract and avoid infection.
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