Laparoscopic nephrectomy for a single-system ectopic ureter draining a small, dysplastic and poorly functioning kidney in children.
OBJECTIVE
To assess the efficacy of laparoscopic nephrectomy for a single-system ectopic ureter draining a dysplastic kidney in children.


METHODS
Between February 1999 and September 2005, 16 girls with a mean age of 6.2 years (range: 2-15 years) presented with urinary incontinence accompanied by regular voiding since birth (15 patients) and vaginitis (one patient). Ultrasonography, intravenous urography and a 99mTc-DMSA renal scan showed the presence of only a single kidney in all cases. Computed tomography (CT) showed a dysplastic kidney definitely in nine patients, structures suspicious of dysplastic kidney in three cases, and no dysplastic kidney in four cases. Magnetic resonance imaging was carried out in the four cases with non-visualized dysplastic kidneys by CT, and showed a suspicious lesion in only one case, and no lesion in the other three patients. All patients underwent transperitoneal laparoscopic nephrectomy for a dysplastic kidney.


RESULTS
Laparoscopy identifies all dysplastic kidneys easily, even in those cases in which dystrophic kidney could not be identified by preoperative imaging. Dysplastic kidneys and ectopic ureters were removed successfully in all 16 patients. Mean operative time was 109 min (range: 40-155 min) with little intraoperative bleeding. Mean postoperative hospital stay was 2.6 days (range: 2-4 days). No intraoperative complication was encountered, except in one single case, in which a small bowel injury occurred during open Hasson's procedure. All patients became dry soon after the operation.


CONCLUSIONS
Laparoscopic nephrectomy for an ectopic ureter draining into a dysplastic kidney is a safe and effective method, and can be carried out successfully, despite a failure by preoperative imaging studies to localize the dysplastic kidney.
Jeong
Byong Chang
BC
Department of Urology, Seoul National University Boramae Hospital, Seoul, Korea.
Lim
Dae Jung
DJ
Lee
Sang Chul
SC
Choi
Hwang
H
Kim
Hyeon Hoe
HH
D000015:Abnormalities, Multiple / Q000601:surgery*; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007668:Kidney / Q000002:abnormalities* / Q000601:surgery*; D010535:Laparoscopy; D009392:Nephrectomy / Q000379:methods*; D014513:Ureter / Q000002:abnormalities* / Q000601:surgery*