S118 Laparoscopic Upper Pole Heminephrectomy in Adults

Dönmez, Muhammet İrfan; Yazıcı, Mustafa; Koni, Artan; İnci, Kubilay; Bilen, Cenk Yücel

doi:10.1016/s1569-9056(13)60310-3

Cited by 5 publications

(14 citation statements)

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“…Ultrasonography (US) is considered the first-line investigation for urinary tract malformations in general 1. However, with reference to duplex kidney systems, the dysplastic upper pole moiety and ectopic ureter may be difficult to fully evaluate with US 2.…”

Section: Discussionmentioning

confidence: 99%

“…The prevalence of such an abnormality is reported as 1 in 125 1. The upper pole moiety is often observed as dysplastic and poorly functional 1 2.…”

Section: Introductionmentioning

confidence: 99%

“…The prevalence of such an abnormality is reported as 1 in 125 1. The upper pole moiety is often observed as dysplastic and poorly functional 1 2. Importantly, duplex kidneys are understood to be associated with ureteroceles, vesicoureteral reflux and ectopically positioned ureters 1.…”

Section: Introductionmentioning

confidence: 99%

“…The upper pole moiety is often observed as dysplastic and poorly functional 1 2. Importantly, duplex kidneys are understood to be associated with ureteroceles, vesicoureteral reflux and ectopically positioned ureters 1. Consequently, individuals typically present with symptoms of voiding dysfunction, urinary tract infections and urinary incontinence 1.…”

Section: Introductionmentioning

confidence: 99%

“…Importantly, duplex kidneys are understood to be associated with ureteroceles, vesicoureteral reflux and ectopically positioned ureters 1. Consequently, individuals typically present with symptoms of voiding dysfunction, urinary tract infections and urinary incontinence 1. Very rarely, an ectopic duplex ureter may drain directly into the female genital tract.…”

Section: Introductionmentioning

confidence: 99%

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Robotic partial nephrectomy for duplex kidney with ectopic ureter draining in the vagina in an adult patient with urinary incontinence

Mahmood¹,

Hadjipavlou

Das

et al. 2017

BMJ Case Reports

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A duplex kidney system with an ectopic ureter draining into the vagina is a congenital malformation that typically presents as refractory urinary incontinence. Diagnosis is often difficult to establish and delayed due to a low incidence. We present the case of a patient aged 26 years with a life-long history of persistent urinary incontinence. Initial presentation was at childhood; however, the diagnosis went undetermined for 22 years. CT urography revealed a duplex kidney with an atrophic upper pole associated with an ectopic ureter that drained into the vaginal vault. This is the first description of such a case being managed successfully via a robot-assisted partial nephrectomy approach. Ectopic ureteral duplication should be considered in the differential diagnosis for young women with refractory urinary incontinence. Robotic partial nephrectomy is a safe and effective technique to manage such cases.

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Section: Discussionmentioning

confidence: 99%

“…The prevalence of such an abnormality is reported as 1 in 125 1. The upper pole moiety is often observed as dysplastic and poorly functional 1 2.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Robotic partial nephrectomy for duplex kidney with ectopic ureter draining in the vagina in an adult patient with urinary incontinence

Mahmood¹,

Hadjipavlou

Das

et al. 2017

BMJ Case Reports

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Diagnosis and surgical outcomes of ectopic ureters in adults: A case series and literature review

Toia

Pakzad

Hamid

et al. 2019

Neurourology and Urodynamics

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Objectives To evaluate functional outcomes of surgery in patients with ectopic ureters diagnosed in adulthood; to review the world literature. Patients and methods Patients were referred over 10 years. Data including surgical history, presenting symptoms, diagnostic modalities, interventions and functional outcomes were collected; and the world literature reviewed. Results 9 women and 1 man had a mean age of 37 (range 20‐58). All women were referred with lifelong leakage. The man was referred with storage LUTS. Three women had heminephrectomy/nephrectomy with the distal ureter left in‐situ prior to referral. MRI was the predominant diagnostic tool but often took senior review to confirm the diagnosis. Excision of the ectopic ureter was performed with bladder neck reconstruction in 6 women, with concomitant rectus fascial sling in one patient. 4 of 6 (67%) women were cured of their stress incontinence with the bladder neck reconstruction alone, whilst two required further intervention. Three women had nephroureterectomy alone as primary treatment of which two were cured. The single male had heminephrectomy and excision of seminal vesicle. Conclusions Ectopic ureter is a rare diagnosis in adults but should be considered in patients who describe lifelong incontinence. Fine slice MRI is the imaging of choice. Excision of the ureter with bladder neck reconstruction alone was successful in two‐thirds of patients, whilst further stress urinary incontinence surgery was required in one‐third. Malignancy in ureteric remnants is described in 8% of the world literature. Patients should be counselled of this risk if the ureter is left in‐situ.

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Surgical Treatment of Duplicated Collecting System in 185 Children: A Single-Center Experience

Liu,

Yu,

Yang

et al. 2023

Preprint

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Background Duplicated collecting system (DCS) is a common congenital urinary tract anomaly in children. It can manifest as complete duplicated collecting system (CDS) or incomplete duplicated collecting system (IDS). While many DCS cases are asymptomatic, some children experience complications such as hydronephrosis, urinary tract infections, incontinence, and vesicoureteral reflux (VUR), which are often associated other urinary tract anomalies, mainly affecting the upper pole moiety. Surgical intervention is frequently required, and various surgeries are now available. Patients and Methods: This retrospective study analyzed data from 185 pediatric patients with DCS who underwent surgical treatment between 2012 and 2021. The choice of surgical approach was based on a comprehensive evaluation by experienced pediatric urologists. The study included different procedures: upper pole heminephrectomy (UHN), endoscopic ureterocele incision (EUI), upper ureteric reimplantation (UIR), and pyeloureteroplasty (PUP). Result Results showed that UHN led to complete resolution of hydronephrosis and incontinence in 127 cases. However, 9 (7.1%) experienced febrile urinary tract infections, 5 (3.9%) experienced ureteral stump syndrome, 3 (2.4%) experienced residual renal atrophy and 8 (6.3%) required reoperations. Comparison between laparoscopic and open UHN revealed the benefits of laparoscopic techniques, including shorter hospitalization and fewer complications. EUI provided a minimally invasive option with significantly reduced hospitalization and resulted in reduced hydronephrosis, although 6 (17.6%) cases experienced febrile urinary tract infections (fUTIs) and 4 (11.8%) needed additional surgeries. UIR was successful in relieving incontinence and hydronephrosis, but 1 (5.9%) experienced fUTIs and 1 (5.9%) required reoperation. PUP also resulted in reduced hydronephrosis without complications. No statistically significant difference existed in rates of unplanned reoperations and fUTIs between UHN and nephron-sparing surgeries. Conclusion Our experience underscores the effectiveness and safety of UHN, especially when utilizing laparoscopic techniques, to treat DCS, resulting in fewer complications. Procedures like UIR, EUI, and PUP, designed to preserve the duplicated moiety, have proven safe and effective, minimizing renal trauma, and preserving renal function.

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S118 Laparoscopic Upper Pole Heminephrectomy in Adults

Cited by 5 publications

References 0 publications

Robotic partial nephrectomy for duplex kidney with ectopic ureter draining in the vagina in an adult patient with urinary incontinence

Robotic partial nephrectomy for duplex kidney with ectopic ureter draining in the vagina in an adult patient with urinary incontinence

Diagnosis and surgical outcomes of ectopic ureters in adults: A case series and literature review

Surgical Treatment of Duplicated Collecting System in 185 Children: A Single-Center Experience

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