title: Multiple successful revisions of a ventriculoureteral shunt without nephrectomy for the treatment of hydrocephalus: case report.
abstract: OBJECTIVE
  Ventriculoureteral shunts have been described occasionally for patients with complicated hydrocephalus. Repeated successful revision of the distal end of such a shunt has not been reported previously. We report a case in which this was achieved.
  
  
  METHODS
  A 21-year-old woman with long-standing hydrocephalus, numerous prior shunt revisions and failures, and several distal shunt sites was shunted successfully into her right ureter.
  
  
  METHODS
  On two occasions, proximal shunt infections required shunt externalization, and the distal end was reinserted successfully into the same distal ureter both times. The patient recovered well from surgery with no clinical evidence of shunt malfunction.
  
  
  CONCLUSIONS
  Multiple distal target failures are an unusual but difficult problem in patients with hydrocephalus. Ventriculoureteral shunts without nephrectomy should be considered, and they can be reused successfully if necessary.
authors.affiliation: Department of Neurosurgery, Children's Hospital, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. cohaegbulam@partners.org
authors.forename: Chima
authors.initials: C
authors.lastname: Ohaegbulam
authors.forename: Craig
authors.initials: C
authors.lastname: Peters
authors.forename: Liliana
authors.initials: L
authors.lastname: Goumnerova
mesh_terms: D000328:Adult; D002557:Cerebrospinal Fluid Shunts / Q000379:methods*; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000601:surgery*; D009392:Nephrectomy; D012086:Reoperation / Q000379:methods*