title: [Laparoscopic ureterovesical repair for megaureter treatment].
abstract: BACKGROUND
  An alternative treatment for obstructive and refluxing obstructive megaureter with ureterovesical junction maintenance through laparoscopy is proposed.
  
  
  METHODS
  The series consists of 8 cases, all of them studied because of prenatal hydronephrosis or febrile urinary tract infection. Seven were diagnosed with obstructive megaureter and one with obstructive refluxing megaureter. The procedure consisted in incising the stenotic portion of the ureter longitudinally and maintaining its posterior wall attached to the bladder, the anterior wall of the ureter was anastomosed transversally to the bladder mucosa in order to liberate the obstruction.
  
  
  RESULTS
  Two of the 8 cases were women and 6 were male. They were aged between 5 months and 11 years (average age of 2.9 years). The surgical time varied between 90 and 120min, with a 48h hospital stay. The permanence of the vesical catheter and the double J stent was of 48h and 6 weeks, respectively. A female patient developed febrile urinary tract infection one week after the surgical procedure. The rest of the patients remained asymptomatic, with normal urinalysis and quarterly urine culture results. Six months after the procedure, the ultrasound showed improvement of the ureteral diameter and of the pyelocaliceal ectasia. The average follow-up was of 2 years.
  
  
  CONCLUSIONS
  The handling of stenosis with longitudinal incision of the ureter and transverse anastomosis to the bladder mucosa, seems promising. The laparoscopic approach allows to identify clearly the longitude of the stenotic segment and join with relative precision such opening with the one of the vesical mucosa.
authors.affiliation: Servicio de Urología, Hospital de Pediatría «Silvestre Frenk Freud», Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México. Electronic address: milanda@prodigy.net.mx.
authors.forename: Sergio
authors.initials: S
authors.lastname: Landa-Juárez
authors.affiliation: Servicio de Urología, Hospital de Pediatría «Silvestre Frenk Freud», Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México.
authors.forename: Alejandra
authors.initials: A
authors.lastname: Guerra-Rivas
authors.affiliation: Servicio de Urología, Hospital de Pediatría «Silvestre Frenk Freud», Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México.
authors.forename: Ramón
authors.initials: R
authors.lastname: Salgado-Sangri
authors.affiliation: Servicio de Urología, Hospital de Pediatría «Silvestre Frenk Freud», Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México.
authors.forename: Ana María
authors.initials: AM
authors.lastname: Castillo-Fernandez
authors.affiliation: Servicio de Urología, Hospital de Pediatría «Silvestre Frenk Freud», Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México.
authors.forename: Hermilo
authors.initials: H
authors.lastname: de la Cruz-Yañez
authors.affiliation: Departamento de Estudios de Posgrado, Facultad de Medicina, Universidad Nacional Autónoma de México, Ciudad de México, México.
authors.forename: Carlos
authors.initials: C
authors.lastname: Garcia-Hernandez
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D002648:Child; D002675:Child, Preschool; D004108:Dilatation, Pathologic / Q000150:complications / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006869:Hydronephrosis / Q000150:complications / Q000196:embryology; D007223:Infant; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D015607:Stents; D013536:Suture Techniques; D014513:Ureter / Q000002:abnormalities / Q000601:surgery*; D014517:Ureteral Obstruction / Q000209:etiology / Q000601:surgery*; D001743:Urinary Bladder / Q000601:surgery*; D014546:Urinary Catheterization; D014552:Urinary Tract Infections / Q000150:complications; D014718:Vesico-Ureteral Reflux / Q000150:complications*
keywords: Laparoscopia; Laparoscopy; Megaureter; Megauréter; Obstrucción ureteral; Pyelography; Stents; Ureter; Ureteral obstruction; Urografía; Uréter