Nondismembered ureteroplasty for congenital midureteral stenosis: a new application of an old technique.
OBJECTIVE
To share our experience with nondismembered ureteroplasty (NDU), a novel application of an old technique in congenital midureteral stenosis (CMS).


METHODS
A 35-year-old man was diagnosed as a case of CMS, a rare benign condition on the basis of extensive evaluation, including ultrasonography, intravenous urography, ethylenedicystine renal scan, antegrade and retrograde contrast study of the left kidney and ureter, and a 64-slice computed tomographic angiography of the abdomen with 3-dimensional reconstruction. He was managed by open NDU, where a longitudinal incision over the narrowed segment was closed transversely using the Heineke-Mikulicz principle, thereby preserving the midureteral blood supply, which is considered tenuous.


RESULTS
The patient had a successful outcome and is asymptomatic at 1-year follow-up, with significant resolution of hydroureteronephrosis on ultrasonography, and a nonobstructed left kidney with 37% differential renal function on renal scan.


CONCLUSIONS
Nondismembered ureteroplasty is a meticulous surgical technique emphasizing blood supply preservation; it can be a useful option in relatively long-segment CMS and adds another method in the surgeon's armamentarium for repairing this rare condition. This technique can be especially useful during laparoscopic or robotic repair of such stenosis.
Goel
Apul
A
Department of Urology, Chhatrapati Shahuji Maharaj, Medical University (Upgraded King George's Medical College), Uttar Pradesh, India.
Singh
Dharamveer
D
Sengottayan
Vengetesh K
VK
Sankhwar
Satyanarayan
S
D000328:Adult; D006801:Humans; D006869:Hydronephrosis / Q000209:etiology / Q000601:surgery; D021621:Imaging, Three-Dimensional; D007431:Intraoperative Complications / Q000517:prevention & control; D007511:Ischemia / Q000517:prevention & control; D008297:Male; D015607:Stents; D036542:Tomography, Spiral Computed; D014463:Ultrasonography; D014513:Ureter / Q000002:abnormalities / Q000098:blood supply / Q000000981:diagnostic imaging / Q000601:surgery*; D014517:Ureteral Obstruction / Q000150:complications / Q000151:congenital / Q000000981:diagnostic imaging / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*