Management of Ectopic Ureters: Experience With the Upper Tract Approach

Plaire, J. Chadwick; Pope, John C.; Kropp, Bradley P.; Adams, Mark C.; Keating, Michael A.; Rink, Richard C.; Casale, Anthony J.

doi:10.1016/s0022-5347(01)64442-2

Cited by 75 publications

(42 citation statements)

References 11 publications

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“…In all of our cases it was left open, with no adverse consequences. Since our patients did not have antenatal diagnosis, their medium age of treatment was 12 years, in contrast to that described in the literature (from six months to five years) (1,3,12,19). One of them had even been pregnant and had a normal delivery before duplex system with infrasphincteric ectopic ureter was diagnosed.…”

Section: Discussionmentioning

confidence: 63%

Laparoscopic ureteropyeloanastomosis in the treatment of duplex system

et al. 2012

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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

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Section: Discussionmentioning

confidence: 63%

Laparoscopic ureteropyeloanastomosis in the treatment of duplex system

et al. 2012

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“…Plaire et al showed that a secondary removal of the ureteral stump was necessary in only 12% of patients who underwent heminephrectomy 8 . However, no patient with urinary incontinence without urinary infection underwent stump removal in their series 8 . In our case, the distal part of the ectopic ureter was not removed since the patient did not have any previous urinary tract infection.…”

Section: Discussionmentioning

confidence: 99%

Ivp İle Saptanamayan Az Fonksi̇yonlu Ve Ektopi̇k Üretere Drene Olan Üst Pol Böbreği̇n Mru İle Saptanmasi

Temiz¹,

Şimşěk²,

Güran³

et al. 2015

Marmara Medical Journal

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Ectopic ureter draining a poorly functioning renal moiety can be missed by classical radiological methods such as ultrasonography, voiding cystourethrogram and intravenous pyelogram. In such conditions, use of computerized tomography and magnetic resonance imaging have been advocated to diagnose poorly functioning, abnormal duplex collecting system and ectopic ureter. A case of a 16-year old girl with continuous dribbling incontinence and normal IVP and cystoscopy findings whose ectopic ureter and duplicated system could only be diagnosed by MRU is presented in this case report.

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“…On this point, controversies arise regarding further management of the distal refluxing ureteral remnant. There have been advocates [2,8,9] for complete removal of ureteral remnant. Recently, two subsets of studies on management of the persistent ureteral stumps following nephrectomy for a vesicoureteral reflux have been reported.…”

Section: Discussionmentioning

confidence: 99%

Natural History of Refluxing Distal Ureteral Stumps following Upper Tract Surgery in Children with Ectopic Ureter or Ureterocele

Kim¹,

Kim²,

Oh³

2001

Urol Int

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Background: It is a difficult problem to manage refluxing distal ureteral stumps after an upper tract approach in the ectopic ureter and ureterocele. We evaluated the natural history of the remaining refluxing distal ureteral stumps through a close follow-up. Patients and Methods: From 1991 to 1998, nine patients with the ectopic ureter or ureterocele, whose age ranged from one to 20 (median 5.0) months, had undergone an upper tract surgery for ectopic ureter (2) or ectopic ureterocele (7). The upper tract surgery for ureterocele or ectopic ureter included a total nephrectomy (2), a partial nephrectomy (6) or a proximal ureteroureterostomy (1), leaving distal ureteral stump. We evaluated the clinical results of the remaining ureteral stumps every 6 or 12 months. The postoperative follow-up period was 51 (median; range 21–96) months. Results: Among the 9 patients, 5 showed disappearance of the reflux and a markedly reduced stump size in the follow-up study. Improvement was noted in 4 patients within 6 months and in 1 by 20 months postoperatively. Two patients subsequently underwent a bladder level surgery due to problems not associated with the ureteral stump itself. Two patients have been followed up for 30 and 39 months, but without any improvement. An intermittent asymptomatic bacteriuria was noted in all patients during the follow-up, but no patient suffered from symptomatic urinary tract infection requiring an additional surgery. Conclusions: Since refluxing distal ureteral stumps were spontaneously resolved in more than half of the cases and did not cause significant problems during the follow-up, it is not necessary to remove the refluxing ureter simultaneously at the time of the upper tract surgery.

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Management of Ectopic Ureters: Experience With the Upper Tract Approach

Cited by 75 publications

References 11 publications

Laparoscopic ureteropyeloanastomosis in the treatment of duplex system

Laparoscopic ureteropyeloanastomosis in the treatment of duplex system

Ivp İle Saptanamayan Az Fonksi̇yonlu Ve Ektopi̇k Üretere Drene Olan Üst Pol Böbreği̇n Mru İle Saptanmasi

Natural History of Refluxing Distal Ureteral Stumps following Upper Tract Surgery in Children with Ectopic Ureter or Ureterocele

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