Laparoscopic ureteropyeloanastomosis in the treatment of duplex system

Abstract

Purpose: Duplex system is one of the most common anomalies of upper urinary tract. Anatomical and clinical presentation determine its treatment. Usually, the upper moiety has a poor function and requires resection, but when it is not signifi cantly impaired, preservation is recommended. Laparoscopic reconstruction with upper pole preservation is presented as an alternative treatment. Materials and Methods: Four female patients with duplex system, one presenting with recurrent urinary tract infection and the others with urinary incontinence associated to infrasphincteric ectopic ureter, were treated. Surgical procedure envolved a laparoscopic ureteropyeloanastomosis of the upper pole ureter to the pelvis of the lower moiety, with prior insertion of a double J stent. Results: Surgical time varied from 120 to 150 minutes, with minimal blood loss in all cases. Follow-up varied from 15 to 30 months, with resolution of the clinical symptoms and preservation of the upper moiety function. Conclusion: Laparoscopic ureteropyeloanatomosis is a feasible and safe minimally invasive option in the treatment of duplex system. Laparoscopic ureteropyeloanastomosis in the treatment

Congenital Anomalies of the Kidney and the Urinary Tract (CAKUT)

“…When the infection becomes persistent, it can also lead to a severe chronic pyelonephritis, which ultimately produces chronic renal disease. A relatively recent treatment modality for pediatric urologic anomalies is laparoscopic polar nephrectomy with ureteropyeloanastomosis [ 4 ]. The procedure involves a surgical anastomosis of the upper pole ureter to the renal pelvis draining the lower pole, with prior insertion of a double J stent.…”