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Vesical continence in bilateral ectopic single ureters
E Podestà1, P L Scarsi, E Di Rovasenda
1Department Pronto Soccorso Chirurgico, Giannina Gaslini Institute, Genoa, Italy.
The Journal of Urology
|May 24, 2001
Summary
Children with bilateral ectopic ureters can achieve normal bladder function and capacity. Surgical reimplantation of ureters can restore bladder function and continence, avoiding urinary diversion.
Area of Science:
- Pediatric Urology
- Reconstructive Surgery
Background:
- Bilateral ectopic ureters present a complex challenge in pediatric urology.
- Achieving bladder capacity and continence is often difficult without urinary diversion.
Purpose of the Study:
- To evaluate the potential for achieving bladder capacity and continence in patients with bilateral ectopic ureters.
- To assess surgical outcomes without resorting to urinary diversion or bladder neck reconstruction.
Main Methods:
- Retrospective analysis of 8 girls with bilateral ectopic ureters treated over 10 years.
- Surgical techniques included cross-trigonal reimplantation and extravesical resection.
- Advanced imaging (ultrasonography, cystography, MRI) used for preoperative assessment.
Main Results:
- Successful ureteral reimplantation achieved acceptable continence and bladder capacity in most patients.
- One patient required a Mitrofanoff principle sigmoid neobladder due to severe bladder dysfunction.
- Urodynamic follow-up confirmed satisfactory bladder function and continence post-surgery.
Conclusions:
- Bilateral ectopic ureters do not preclude normal bladder function and capacity.
- Surgical correction can lead to successful voiding and continence, preserving the native bladder.
- This approach offers a viable alternative to urinary diversion for selected pediatric patients.