Inverted Ureteral Nipple as Antireflux Technique in Surgical Management of Bilharzial Ureteral Strictures

Abou-Elela, Ashraf; Torky, Mohamed; Salah, Essam; Morsy, Ahmed; El‐Sherbiny, M.

doi:10.1016/j.urology.2010.01.065

Cited by 10 publications

(6 citation statements)

References 15 publications

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“…The eversion of the ureteral end for ureteroneocystostomy reduces postoperative restricture [17-20]. Although ureteral intussusception to produce a nipple is considered an important part of ureteral reimplantation in open surgery, it has never been reported accompanying laparoscopic ureteroneocystostomy.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Ureteroneocystostomy: Modification of Current Techniques

et al. 2013

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PurposeTo review the feasibility of laparoscopic ureteroneocystostomy with extracorporeal eversion of the ureteral end in various distal ureteral lesions.Materials and MethodsWe conducted a retrospective review of 5 laparoscopic procedures of ureteroneocystostomy with extracorporeal eversion of the ureteral end. Of these, 4 patients (range, 45 to 54 years) had distal ureter stricture or obstruction after gynecological surgeries for endometriosis or a large uterine myoma. One patient (male, 67 years) had low-grade distal ureter cancer. The laparoscopic procedure was combined with cystoscopic insertion of a ureteral stent and extracorporeal eversion of the ureter through the 10-mm port on the affected side.ResultsThe laparoscopic ureteral reimplantations with and without a psoas hitch in patients with distal ureteral lesions was successful in all patients. The mean operation time was 137 minutes (range, 104 to 228 minutes). Two patients underwent additional psoas hitch. In all patients, short-term success was confirmed by voiding cystourethrography and intravenous pyelography conducted 3 months after the operation. The mean follow-up of the entire group was 12 months (range, 3 to 30 months). We noted no major or minor complications over the follow-up period.ConclusionsThe technique of laparoscopic ureteroneocystostomy for benign or malignant ureteral strictures continues to evolve. Surgeons should be versatile with various options and technical nuances when dealing with these cases. Simple modifications of laparoscopic ureteroneocystostomy with extracorporeal eversion of the ureteral end, nonreflux extravesical anastomosis, and simultaneous cystoscopy will be crucial to the ease of performance and a successful outcome.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic Ureteroneocystostomy: Modification of Current Techniques

et al. 2013

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“…In the present study, we describe the technique of embedded-nipple ureteroneocystostomy for paediatric re-implantation of POM. The nipple procedure is a safe and simple anti-reflux technique, with a high success and low complication rate [6] , [7] , [8] , [9] . The present technique includes an additional step after nipple formation by fixing the nipple edges to the bladder wall.…”

Section: Discussionmentioning

confidence: 99%

The embedded nipple: An optimal technique for re-implantation of primary obstructed megaureter in children

Youssif

Fahmy

Rashad

et al. 2016

Arab Journal of Urology

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ObjectivesTo present a novel ureteric re-implantation technique for primary obstructed megaureter (POM) that ensures success in the short- and long-term, as conventional techniques are not ideal for megaureters especially in children, with ureteric stenosis and reflux being common complications after re-implantation.Patients and methodsBetween 2009 and 2012, 22 paediatric patients with POM were enrolled. We performed a new technique for re-implantation of these ureters to ensure minimal incidence of ureteric strictures and easy subsequent endoscopic access. We performed follow-up voiding cystourethrography (VCUG) at 6 months postoperatively.ResultsThe cohort comprised 14 boys and eight girls, with a median age of 22 months. Six patients underwent bilateral re-implantation. The mean (range) duration of indwelling ureteric catheterisation was 7.8 (4–14) days. There were no complications in the perioperative and postoperative periods. There was no reflux on follow-up VCUG in any of the patients. One patient developed Grade I reflux after 1 year and presented with a urinary tract infection. Diagnostic cystoscopy was performed in 13 patients showing that the nipple was directed similarly to the native ureteric orifice.ConclusionThe embedded-nipple technique for re-implantation of POM guarantees successful results and permits easy subsequent ureteroscopic access when needed.

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“…All had good results with no reflux. Abou-Elela A, et al [14] used the nipple valve reimplantation for 36 bilharzia patients with 56 ureters. There was no reflux reported except 2 stenosis at the ureterovesical anastomosis.…”

Section: Figurementioning

confidence: 99%

Does the Nipple Valve Ureteral Reimplantation Work in Infants?

Thach¹,

Son²,

Thai³

et al. 2020

Mathews Journal of Pediatrics

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Ureteral reimplantation with or without tapering is a common procedure in pediatric urology for obstructed megaureter. However, as for under one year old children, besides support opinions [1][2][3][4], there is no consensus about these conventional reimplantations because they could cause ureteral stenosis, even permanent neurologic lesions [5,6]. In the surgical treatment of obstructed megaureter, to avoid these complications, some other techniques may be used as temporary procedures, such as double J ureteral stenting [7], cutaneous ureterostomy [8], temporary refluxing ureteral reimplantation [9,10], while waiting for bladder growth when conventional reimplantation can safely be performed. Temporary refluxing ureteral reimplantation has been recommended for primary obstructed megaureter [11]. We present the direct refluxing ureteral reimplantation

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Inverted Ureteral Nipple as Antireflux Technique in Surgical Management of Bilharzial Ureteral Strictures

Cited by 10 publications

References 15 publications

Laparoscopic Ureteroneocystostomy: Modification of Current Techniques

Laparoscopic Ureteroneocystostomy: Modification of Current Techniques

The embedded nipple: An optimal technique for re-implantation of primary obstructed megaureter in children

Does the Nipple Valve Ureteral Reimplantation Work in Infants?

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