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

Youssif, Tamer Abou; Fahmy, Ahmed; Rashad, Hazem; Atta, Mohamed A.

doi:10.1016/j.aju.2016.04.001

Cited by 5 publications

(3 citation statements)

References 22 publications

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“…Open surgery was used for all children. Embedded nipple technique was our preferred way of reimplantation to all children [7]. Success of surgery was defined as complete resolution of VUR at one year after surgery.…”

Section: Methodsmentioning

confidence: 99%

A new insight into the management of high-grade vesicoureteral reflux

Atta¹,

Ismail²,

Kotb³

2022

polp

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Introduction: High-grade vesicoureteral reflux (VUR) is a major dilemma to urologists, with no clear time for intervention in children without evidence of urinary tract infection. The aim of our study was to show our experience in managing high-grade VUR in children with high postvoiding residual. Material and methods: Our study included 24 children with high-grade reflux persistent while being on surveillance and continuous antibiotic prophylaxis. Besides radiological investigations, 24-hour urine output and postvoiding residual were our main clinical parameters to study. Results: All the children with high-grade reflux in our study were found to have polyuria and high postvoiding residual. Surgical correction was done through open surgical ureteral reimplantation combined with the use of vasopressin. Reduction cystoplasty was done for 2 children. One-year follow-up showed satisfactory outcomes in reducing bladder capacity and treating reflux. Conclusions: Children with high-grade VUR should be assessed for polyuria. The presence of polyuria should be an indication for early surgical management.

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Section: Methodsmentioning

confidence: 99%

A new insight into the management of high-grade vesicoureteral reflux

Atta¹,

Ismail²,

Kotb³

2022

polp

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“…They created the submucosal tunnel with a 20mm nipple. Abou Youssif TM, et al [16] used the embedded nipple to repair the obstructed megaureter in children. They created the bed for the nipple by cauterize the bladder mucosa.…”

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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“…Various approaches have been described for the correction of the same. [ 3 4 ] Open techniques were considered as gold standard until laparoscopic techniques were refined. [ 5 6 7 ] Results of open techniques were mimicked by laparoscopic techniques.…”

Section: Introductionmentioning

confidence: 99%

Novel technique of laparoscopic extravesical ureteric reimplantation in primary obstructive megaureter

et al. 2017

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Objective:This study aims to demonstrate a novel laparoscopic technique of tapering megaureter without disrupting the blood supply and disconnecting the ureter.Materials and Methods:Eight cases of primary obstructive megaureter in the age group of 14–22 years underwent laparoscopic extravesical ureteric reimplantation between August 2011 and July 2015 using our novel technique. Five patients had obstruction on left side and three on right side. Follow-up ultrasonography at 1 month and 3 months, voiding cystourethrogram (VCUG) at 3 months and intravenous urogram (IVU) at 6 months was obtained to assess the development of reflux and to look for adequate drainage of the obstructive ureter.Results:Average age of the patients at the time of surgery was 18.5 years. Mean operating time was 95 min. Mean blood loss of 20 ml. VCUG done after 3 months showed no reflux in all cases. IVU done after six months showed no obstruction and complete drainage of dye.Conclusion:Our technique of tapering obstructed megaureter over a preplaced ureteral dilator is time saving and also helps in preserving blood supply to lower ureter. As a result, ureteric anastomotic stricture rate is very low. It is easily reproducible in the open as well as by robotic.

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

Cited by 5 publications

References 22 publications

A new insight into the management of high-grade vesicoureteral reflux

A new insight into the management of high-grade vesicoureteral reflux

Does the Nipple Valve Ureteral Reimplantation Work in Infants?

Novel technique of laparoscopic extravesical ureteric reimplantation in primary obstructive megaureter

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