Laparoscopy for definite localization and simultaneous treatment of ectopic ureter draining a dysplastic kidney in children.
OBJECTIVE
Single-system ectopic ureter draining a dysplastic kidney is a rare urologic abnormality. In this study, we evaluated our own experience using laparoscopy for the simultaneous identification and removal of such ureterorenal units.


METHODS
Between February 1999 and August 2001, four girls with a mean age of 11 years presented with urinary incontinence. After imaging studies including CT scan, MRI, or both were done, all the patients underwent laparoscopy for definitive localization and simultaneous treatment.


RESULTS
In all cases, ultrasonography and intravenous urography combined to reveal a single normal kidney. Even the CT scan could not identify the dysplastic kidney or ectopic ureter in three children. Laparoscopy was performed transperitoneally in all four patients, and a small dysplastic kidney was identified. Discovery of the kidney was not difficult because we initially identified the ureter crossing over the iliac vessels. Laparoscopic nephroureterectomy was successful in all patients with a mean operative time of 102 minutes. There was no significant intraoperative or postoperative complication, and the mean postoperative hospital stay was 2.5 days. All patients have remained completely dry without any problems after surgery.


CONCLUSIONS
For patients having a clinical suspicion of ectopic ureter draining a dysplastic kidney, laparoscopy may represent an alternative modality for simultaneous diagnosis and treatment.
Kim
Hyeon Hoe
HH
Department of Urology, Seoul National University College of Medicine and Clinical Research Institute, Korea. hhkim@snu.ac.kr
Kang
Jeongyoon
J
Kwak
Cheol
C
Byun
Seok-Soo
SS
Oh
Seung-June
SJ
Choi
Hwang
H
D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D007668:Kidney / Q000002:abnormalities*; D010535:Laparoscopy / Q000379:methods*; D008279:Magnetic Resonance Imaging; D009392:Nephrectomy / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014513:Ureter / Q000002:abnormalities* / Q000601:surgery*; D014549:Urinary Incontinence / Q000209:etiology / Q000601:surgery