Retrograde ureteral access after cross-trigonal ureteral reimplantation: A straightforward technique.
OBJECTIVE
Retrograde ureteral access after cross-trigonal ureteral reimplantation can be challenging. We present our experience with percutaneous retrograde ureteral catheterization, status post cross-trigonal ureteral reimplantation.


METHODS
We evaluated all patients who underwent attempted percutaneous retrograde ureteral catheterization after cross-trigonal ureteral reimplantation. All clinical data, radiographic images and operative reports were reviewed. Ureteral access was obtained by percutaneously entering the bladder with an intravenous needle/catheter under cystoscopic guidance. The needle was then removed leaving the catheter in place. The ureteral orifice was then accessed through the intravenous catheter by a ureteral access wire and/or ureteral catheter under cystoscopic guidance.


RESULTS
From 1978 to 2008, 13 patients (11 boys and 2 girls) with a history of cross-trigonal ureteral reimplantation underwent percutaneous retrograde ureteral catheterization. The procedure was unilateral in 12 patients and bilateral in one. Indications for the procedure included: retrograde pyelography and double-J stent insertion for ureteropelvic junction or ureterovesical junction obstruction (10); removal of migrated stent (2); and treatment of a ureteral stone (1). The procedure was performed successfully in all patients and without complications.


CONCLUSIONS
Percutaneous retrograde ureteral catheterization is a safe, straightforward, and effective modality for obtaining retrograde ureteral access in children, status post cross-trigonal ureteral reimplantation.
Ospedale Maggiore of Bologna, Paediatric Surgery, Bologna, Italy.
Roberto
R
De Castro
Katherine C
KC
Hubert
Jeffrey S
JS
Palmer
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003558:Cystoscopy; D005260:Female; D005548:Foreign-Body Migration / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D008499:Medical Records; D012092:Replantation / Q000009:adverse effects; D015607:Stents / Q000009:adverse effects; D025321:Surgery, Computer-Assisted; D014513:Ureter / Q000601:surgery*; D014517:Ureteral Obstruction / Q000000981:diagnostic imaging / Q000601:surgery; D053039:Ureterolithiasis / Q000209:etiology / Q000628:therapy; D001743:Urinary Bladder / Q000473:pathology / Q000601:surgery; D014546:Urinary Catheterization / Q000379:methods*; D014567:Urography; D014718:Vesico-Ureteral Reflux / Q000601:surgery*; D055815:Young Adult