title: Laparoscopic Intravesical Detrusorrhaphy With Ureteral Plication for Megaureter: A Novel Technique.
abstract: BACKGROUND
  To demonstrate the novel technique of laparoscopic intravesical detrusorrhaphy with ureteral plication for megaureter.
  
  
  METHODS
  From December 2012 to June 2014, 11 patients with primary unilateral megaureter underwent laparoscopic intravesical detrusorrhaphy with ureteral plication. By a transvesicoscopic approach using a 3-port technique, the ureter was mobilized and plicated with a 6F Foley catheter. After dissection of the bladder mucosa in a semilunar shape, the detrusor was incised vertically and repaired underneath the mobilized ureter to create a submucosal tunnel. The ureter was covered with bladder mucosa, and the ureteral orifice was anastomosed to its orthotopic neoureteric orifice. The mean age of the included patients at the time of surgery was 9.18 years (range, 12 months-24 years). All surgeries were successfully completed without open conversion, with a mean operation time of 214 minutes including preoperative evaluation. All patients tolerated the procedure without any complications. Within the mean follow-up duration of 12.6 months (range, 5-24 months), no complications related to the surgery were reported, and no vesicoureteral reflux was detected in the operated side on postoperative voiding cystourethrography. The distal ureteral diameter was significantly reduced (from 21.1 to 11.6 mm), and the grade of hydronephrosis was decreased on postoperative ultrasonography without deterioration of renal function.
  
  
  CONCLUSIONS
  In this study, laparoscopic intravesical detrusorrhaphy with ureteral plication demonstrated successful short-term outcomes in management of megaureter in children and adults. Our technique can be an effective and feasible surgical option in the treatment of megaureter.
authors.affiliation: Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Sang Woon
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Neddy Lee
authors.initials: NL
authors.lastname: Lim
authors.affiliation: Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Yong Seung
authors.initials: YS
authors.lastname: Lee
authors.affiliation: Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Sang Won
authors.initials: SW
authors.lastname: Han
authors.affiliation: Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, South Korea. Electronic address: YJIM@yuhs.ac.
authors.forename: Young Jae
authors.initials: YJ
authors.lastname: Im
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003558:Cystoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D061646:Operative Time; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014513:Ureter / Q000002:abnormalities* / Q000601:surgery; D014515:Ureteral Diseases / Q000151:congenital / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*; D055815:Young Adult