The ventriculo-ureteral shunt: An underused, valuable neurosurgical approach

Lescure, V.; Descazeaud, A.; Caire, François; Salle, Henri

doi:10.1016/j.neuchi.2020.12.007

Cited by 4 publications

(4 citation statements)

References 7 publications

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“…Only a few cases of VU shunts have been reported in the literature and several case reports describe adult patients where the size of the ureters is more favourable for this procedure [6,7,[9][10][11][12][13][14][15][16][17]. One of the few long-term follow-ups described good results in four patients, provided they had a low-pressure urinary bladder without urinary tract infections [16].…”

Section: Discussionmentioning

confidence: 99%

“…Complications such as shunt obstruction, infection (with and without associated urinary tract infection), migration or kinking of the tubing, and metabolic complications were described [16]. Many failures have been described to be due to calcification of the distal catheter, which is a known complication of ureteral stenting [9]. There is also the theoretical risk for retrograde reflux of urine into CSF spaces, although this has not been described in any cases [12].…”

Section: Discussionmentioning

confidence: 99%

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Percutaneously inserted ventriculo-ureteral shunt as a salvage treatment in paediatric hydrocephalus: a technical note

et al. 2022

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Background Hydrocephalus is a challenge for paediatric neurosurgeons. When the abdominal cavity and heart fail as diversion sites for cerebrospinal fluid (CSF), many of the otherwise used alternative diversion sites are not feasible due to the smaller physical body size of children and infants. Using the urinary system as a site of diversion has been described in adults primarily. Objective To describe a minimally invasive procedure to percutaneously access the ureter for placement of a distal catheter in the treatment of paediatric hydrocephalus. Methods A percutaneous ultrasound-assisted technique was used to access the renal pelvis for catheter placement into the distal ureter. Results Fifteen months after the surgery, the child has a stable neurological condition and adequately managed hydrocephalus. Conclusion The urinary tract should be considered a viable option for CSF diversion in complex paediatric hydrocephalus. A multidisciplinary approach consisting of interventional radiologists, urologists and neurosurgeons should be involved in the evaluation of potential candidates.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Percutaneously inserted ventriculo-ureteral shunt as a salvage treatment in paediatric hydrocephalus: a technical note

et al. 2022

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“…[ 13 ] A VU shunt with ureter implantation into a psoas bladder without nephrectomy presented with no side effects 3 months after shunt placement. [ 17 ] Finally, two cases were reported to have no side effects at 4 weeks and 1.5 years following VU placement. [ 18 ] Additional cases were considered successful at relieving hydrocephalus, but they did report treatable side effects; reported side effects included ureter spasm, [ 9 ] dehydration and electrolyte disturbance, [ 10 , 11 ] high wound output, [ 11 ] infection, [ 12 , 16 ] shunt displacement, [ 16 ] and tube kinking.…”

Section: Narrative Reviewmentioning

confidence: 99%

Ventriculoureteral shunt: Narrative review of contemporary cases and its historical role in the development of renal transplantation

Waack

Hoyt

Schroeder

2023

JNRP

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Ventriculo-ureteral (VU) shunting is a little-known method of managing hydrocephalus. This paper reviews contemporary uses of this shunting technique and describes its historical significance to the field of organ transplantation. The ureter may serve as a possible backup, or alternative, distal drainage site compared to the more common peritoneum, atrium, and pleural space. Sporadic contemporary uses of the VU shunt have been reported in unique situations, demonstrating a possible utility in modern neurosurgery. Interestingly, the VU shunt played an important role in the development of kidney transplantation. In the late 1940s and early 1950s, David Hume, a general surgery resident, and colleagues at the PBBH undertook a series of human kidney transplantations. Concurrently, Donald Matson, a pediatric neurosurgeon at Peter Bent Brigham, was utilizing the VU shunt in hydrocephalic patients. Dr. Matson’s VU shunt technique involved total nephrectomy, and some of the kidneys harvested from Dr. Matson’s were used by his general surgery colleagues in their transplantation trials. Although none of the transplanted kidneys from this series were successful, the transplant team in Boston, minus David Hume, went on to perform the world’s first kidney transplant a few years later. This relatively unfamiliar procedure may be applicable to specific situations, and it is of historical importance to the field of transplantation.

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“…Complications such as shunt obstruction, infection (with and without associated urinary tract infection), migration or kinking of the tubing and metabolic complications were described 16 . Many failures have been described to be due to calci cation of the distal catheter, which is a known complication of ureteral stenting 9 . There is also the theoretical risk for retrograde re ux of urine into CSF spaces, although this has not been described in any cases 12 .…”

Section: Outcomementioning

confidence: 99%

Percutaneously inserted ventriculoureteral shunt as a salvage treatment in pediatric hydrocephalus: a technical note

Sandvik

Bartek

Edström

et al. 2022

Preprint

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Background: Hydrocephalus is a challenge for pediatric neurosurgeons. When the abdominal cavity and heart fail as diversion sites for cerebrospinal fluid (CSF), many of the otherwise used alternative diversion sites are not feasible due to the smaller physical body size of children and infants. Using the urinary system as a site of diversion has been described in adults primarily.Objective: To describe a minimally invasive procedure to percutaneously access the ureter for placement of a distal catheter in the treatment of pediatric hydrocephalusMethods: A percutaneous ultrasound-assisted technique, was used to access the renal pelvis for catheter placement into the distal ureter.Results: Fifteen months after the surgery the child has a stable neurological condition and adequately managed hydrocephalus.Conclusion: The urinary tract should be considered a viable option for CSF diversion in complex pediatric hydrocephalus. A multidisciplinary approach consisting of interventional radiologists, urologists and neurosurgeons should be involved in the evaluation of potential candidates.

show abstract

The ventriculo-ureteral shunt: An underused, valuable neurosurgical approach

Cited by 4 publications

References 7 publications

Percutaneously inserted ventriculo-ureteral shunt as a salvage treatment in paediatric hydrocephalus: a technical note

Percutaneously inserted ventriculo-ureteral shunt as a salvage treatment in paediatric hydrocephalus: a technical note

Ventriculoureteral shunt: Narrative review of contemporary cases and its historical role in the development of renal transplantation

Percutaneously inserted ventriculoureteral shunt as a salvage treatment in pediatric hydrocephalus: a technical note

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