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Primary lower urinary tract reconstruction for nonfunctioning renal moieties associated with obstructing ureteroceles
Christopher D Gran1, Bradley P Kropp, Earl Y Cheng
1Department of Urology, University of Oklahoma Health Science Center, 920 Stanton L. Young Boulevard, Oklahoma City, Oklahoma 73104, USA.
The Journal of Urology
|December 14, 2004
Summary
Primary lower urinary tract reconstruction for nonfunctioning renal moieties in children with ureteroceles is a successful alternative to heminephrectomy, offering improved outcomes and minimal complications.
Area of Science:
- Pediatric Urology
- Urologic Oncology
Background:
- Upper pole heminephrectomy is standard for nonfunctioning renal units from ureteroceles, but often requires further surgery.
- This approach may not address bladder-level defects, leading to complications like reflux or infection.
Purpose of the Study:
- To evaluate the success of primary lower urinary tract reconstruction for nonfunctioning renal moieties.
- To assess the morbidity of retaining nonfunctioning renal units in situ.
Main Methods:
- Retrospective review of 16 patients with duplex collecting systems and ureteroceles.
- Definitive lower urinary tract reconstruction performed without upper tract ablative surgery.
Main Results:
- Mean follow-up of 62 months.
- All patients showed resolved or decreased upper tract dilatation; no renal function loss.
- 94% of patients had no persistent reflux; 13% experienced UTIs, with no febrile episodes or new onset hypertension, proteinuria, or tumors.
Conclusions:
- Primary, single-stage lower urinary tract reconstruction is superior to ablative surgery for ureterocele-associated nonfunctioning renal moieties.
- This approach corrects pathology with minimal long-term morbidity and risk.