Ventriculo-ureteric shunt surgery: Thou shalt not be forgotten of me!

Sarkar, Hrishikesh; Karthikeyan, Aswathaman

doi:10.4103/0028-3886.117607

Cited by 7 publications

(5 citation statements)

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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%

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%

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

et al. 2022

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“…It was recommended that ventriculoureteral shunts are used only in selected patients with multiple failures of standard shunts. 33 Ventriculoureteral shunts have been used as recently as 2013 by Sarkar and Karthikeyan 34 in India in a 60-year-old patient with tuberculosis meningitis and hydrocephalus.…”

Section: Discussionmentioning

confidence: 99%

A Case of Recurrent Bacterial Meningitis Due to Retained 54-Year-Old Ureterodural Anastomosis

D’Assumpcao

Sandhu

Heidari

et al. 2018

Journal of Investigative Medicine High Impact Case Reports

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Ventriculoperitoneal shunts are the current treatment of choice for congenital hydrocephalus. It is rare for physicians to see patients with alternative types of shunting devices. Lumboureteral shunts, once popular from the 1940s to 1960s, decompress via the genitourinary system. Immediate complications were dehydration, electrolyte imbalances, infection, and the sacrifice of a functional kidney. Long-term complications include retrograde meningitis due to urinary tract infections. Three shunt types have been documented: polyethylene, silicone rubber, and ureterodural anastomosis. Routine imaging cannot detect a ureterodural anastomosis, and if suspected, computed tomography myelogram is needed for confirmation. This article presents the case of a man with long-standing ureterodural anastomosis that required ligation after recurrent episodes of acute meningitis secondary to urinary retention.

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“…[9] Other side effects have been reported, including ureter spasm, encrustation, ureter wall erosion, ascending infection (UTI associated or non), biofilm formation, retrograde urine reflux, catheter migration, failure of urinary diversion, and tube disconnection/migration. [9][10][11][12][13] Furthermore, most neurosurgery training programs do not include training in genitourinary surgery, so assistance from a urologist may be indicated. [11] Despite these issues, however, the VU shunt was an accepted shunting method before the development of the one-way valve because of the ureter's hydrodynamic resistance.…”

Section: Narrative Reviewmentioning

confidence: 99%

“…[9][10][11][12][13] Furthermore, most neurosurgery training programs do not include training in genitourinary surgery, so assistance from a urologist may be indicated. [11] Despite these issues, however, the VU shunt was an accepted shunting method before the development of the one-way valve because of the ureter's hydrodynamic resistance. [1] Understandably, the VU shunt fell out of favor when superior shunting techniques emerged.…”

Section: Narrative Reviewmentioning

confidence: 99%

“…[ 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. [ 16 ] VU shunting is a relatively unknown procedure that should be considered for appropriate patients.…”

Section: Narrative Reviewmentioning

confidence: 99%

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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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Ventriculo-ureteric shunt surgery: Thou shalt not be forgotten of me!

Cited by 7 publications

References 0 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

A Case of Recurrent Bacterial Meningitis Due to Retained 54-Year-Old Ureterodural Anastomosis

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

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