Is it necessary to perform nephrectomy?

Hello,
I’m a physician from Russia and currently preparing for the Medical Board in US. I have a question regarding my nephew.  My nephew was born in August of 2007 and was diagnosed with nonfunctional hypoplasia of left kidney and ureterocele in the neck of the bladder, particularly on the left posterior wall of the urinary bladder. Diagnostic procedures are listed below:

Infusion urography: hypoplasia and lumbar dystopia of left nonfunctional kidney
Cystoscopy: ureterocele in the neck of the bladder, particularly on the left posterior wall of the urinary bladder
Voiding cystourethrogam: no vesicoureteral reflux
Diuretic nuclear renography (nuclear renal scan): left kidney is not visualized
Ultrasound: left kidney localized lower then normal with size of 39mm by 16 mm, parenchyma dysplastic and can’t be differentiated. Low blood flow in the vessels.
                    Right kidney in typical location with size 72 by 29 mm, parenchyma 10 mm with normal vessels and blood flow
                    Ureter on the left is 12 mm with ureterocele on the end. Ureterocele with diameter of 12 mm
Summary of ultrasound: left nonfunctional kidney, ureterocele on the left

My nephew is developing according to his age and he just turned 1 year old in the last month. During the first year of his life he was completely asymptomatic, no UTI, no urinary retention, no abdominal pain, no abdominal mass. All laboratory studies were normal.
The Russian urologists advise to perform nephrectomy and wait on removing ureterocele. Personally, I disagree with the decision to perform nephrectomy because he is completely asymptomatic. What is the possible outcome and prognosis of this case? Is it necessary to perform nephrectomy?
Any advice would be greatly appreciated. Please can you email me at ***@**** Thank you.

[cheenu73]

My som 27/m was diagnosed as having right sided congenital hydronehrosis with mega ureter and nucear scan revealed the kidney is functioning about 36%and the surgeon did uretero-uretostomy .No vesiculo-ureteric reflux on both sides .This  done when he was 13 and he has grown into fine young man of robust health.USG now shows the same findings ie.anatomicay the hydronehrosis and congenital megacoon are same.I did not take nucear scan again as the attending nehrologist felt too many tests are not  needed now as he have no probem at all now.Please advice.

[cheenu73]

cheenu73
i have posted a question and after going through others i see no answer to anybody's question.I want to know whether i am supposed to wait or am i climbing up wrong tree?