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The kidney bridge procedure for bilateral ureteral loss
Thomas R Hefty1, John M Corman, Ali M Sarram
1Section of Urology and Renal Transplantation, Virginia Mason Medical Center, Seattle, Washington 98111, USA. urotrh@vmmc.org
Urology
|March 23, 2005
Summary
A novel kidney autotransplantation technique bridges ureteral deficits, offering a new solution for bilateral ureteral loss. This method avoids intestinal segments, creating a natural drainage system for both kidneys.
Area of Science:
- Urology
- Nephrology
- Surgical Innovation
Background:
- Bilateral ureteral loss presents significant reconstructive challenges.
- Idiopathic retroperitoneal fibrosis can lead to complex ureteral strictures.
Observation:
- A 61-year-old woman presented with bilateral mid and distal ureteral strictures.
- A novel surgical approach involved autotransplanting the left kidney to the right iliac fossa.
Findings:
- The right ureter was successfully anastomosed to the autotransplanted kidney's pelvis.
- Ureteroneocystostomy was performed, creating an intestine-free drainage system for both kidneys.
- Stable renal function (creatinine 1.7 mg/dL) was maintained at 18 months postoperatively.
Implications:
- This kidney autotransplantation technique offers a viable alternative for managing extensive ureteral defects.
- It provides a physiologically normal, intestine-free reconstruction for bilateral ureteral loss.
- Demonstrates successful long-term renal function preservation after complex ureteral reconstruction.