Ipsilateral ureteroureterostomy and pyeloureterostomy: a review of 15 years of experience with 25 patients.
We reviewed our 15-year experience with pyeloureterostomy and ureteroureterostomy in 25 children with ureteral duplication. Pyeloureterostomy was performed in 5 patients, including 4 with reflux and 1 with upper pole obstruction. The results were good in 4 and in 1 patient postoperative anastomotic obstruction developed. Ipsilateral ureteroureterostomy was performed in 20 patients, including 8 with reflux into 1 or both ipsilateral ureters, 7 with obstructed ectopic upper pole ureters without ureterocele, 4 with ectopic ureteroceles and 1 with incomplete ureteral duplication and obstruction of the common distal ureteral segment. At followup, which ranged from 3 months to 6 years, 17 patients had good postoperative results as demonstrated by improved upper tract drainage and absence of reflux. Of 6 patients who underwent simultaneous ipsilateral ureteral reimplantation at the time of ureteroureterostomy postoperative reflux was noted in 1, necessitating a second procedure. Ureteral stumps were left in 13 patients. Postoperative urinary infection occurred in only 3 of these patients, all as single episodes and 2 associated with persistent contralateral reflux. Significant luminal disparity at the time of ureteroureterostomy was noted in 18 patients and did not adversely affect results.
Huisman
T K
TK
Department of Urology, Naval Hospital, San Diego, California 92134-5000.
Kaplan
G W
GW
Brock
W A
WA
Packer
M G
MG
D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007682:Kidney Pelvis / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D011859:Radiography; D014513:Ureter / Q000002:abnormalities / Q000000981:diagnostic imaging; D014517:Ureteral Obstruction / Q000000981:diagnostic imaging / Q000601:surgery; D014518:Ureterocele / Q000000981:diagnostic imaging / Q000601:surgery; D014519:Ureterostomy / Q000379:methods*; D014552:Urinary Tract Infections / Q000453:epidemiology; D014718:Vesico-Ureteral Reflux / Q000453:epidemiology