Our Experience of Ureteral Substitution in Pediatric Age Group

Undiagnosed ureteroinguinal hernia with solitary kidney in a child with ureteric injury during herniotomy

“…In 1999, EstevaoCosta [16] reported the use of vermiform appendix to bridge a 7-cm-long ureteral defect after traumatic ureteropelvic disruption for the first time in a child. Thereafter, the successful use of this procedure has been reported by various authors [17][18][19], with the youngest patient being 4 months old [17]. A minimally invasive approach has been described in literature with laparoscopic ureteral reconstruction with successful outcomes [20,21].…”

Appendix vermiformis as a left pyelo-ureteral substitute in a 6-month-old girl with solitary kidney

“…[7] In 2003, a method of ileal interposition using the Yang-Monti technique was described and is now well established. [2,8] Successful ureteral substitution with AV in adults and children involving the right, mid to distal ureter, right proximal ureter, pyeloureterostomy and for bridging the right renal pelvis to the left ureter has been reported. [5,[8][9][10][11][12] Replacement of the left ureter bears the special problem of a long distance from the caecum to the left peritoneum depending on the length of the appendix and the mesoappendix.…”

“…Restricted availability after appendectomy, post-inflammatory changes and fibrosis, missing length and a short mesoappendix may limit the use of the appendix. [8][9][10][11][12][13] General concerns using bowel in reconstructive urology, like recurrent urinary tract infection, tumor formation, In general, vascularity of the AV is excellent, the length of the mesoappendix is rarely a limitation and mobilization of the appendix to the left side is easily performed. It can also satisfactorily used for other substitutions such as an appendicovesicostomy [14] or hepaticoportoappendicostomy [15] and in the majority of cases with satisfactory results.…”

Management of a hypoplastic lower urinary tract: a case report

“…Similarly, the use of the appendix or a segment of the reconfigured ileum (Monti tube) as a conduit for clean intermittent catheterization is extensively practiced. The use of ureteric substitutes is not common in pediatric urology, owing to the rarity of conditions necessitating this practice [4]. Much of the evidence available is related to adult ureteric substitutes.…”