Ureterocalyceal anastomosis in children: is it still indicated?
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Updated: Jun 28, 2026
A Murine Model of Irreversible and Reversible Unilateral Ureteric Obstruction
Published on: December 20, 2014
Osama M Sarhan1, Tamer E Helmy, Ashraf T Hafez
1Urology and Nephrology Center, Mansoura University, Mansoura 35516, Egypt. o_sarhan2004@yahoo.com
Insights
Ureterocalyceal anastomosis in children, a surgical technique for complex urinary tract issues, shows an 80% success rate. This procedure is indicated in difficult cases, with nephrectomy reserved for severe renal impairment.
Area of Science:
- Pediatric Urology
- Surgical Techniques
- Renal Function Preservation
Background:
- Ureterocalyceal anastomosis is a reconstructive surgical option for pediatric urinary tract anomalies.
- Indications and outcomes for this procedure in children require further elucidation.
Purpose of the Study:
- To review the experience with ureterocalyceal anastomosis in children.
- To analyze the indications, surgical outcomes, and long-term results.
Main Methods:
- Retrospective review of 10 pediatric cases undergoing open ureterocalyceal anastomosis (2000-2006).
- Assessment of clinical and radiological outcomes, defining success as symptomatic relief and radiographic resolution of obstruction.
Main Results:
- 10 children (mean age 6.5 years) underwent the procedure for failed pyeloplasty (6) or iatrogenic injury (4).
- An 80% overall success rate was achieved, with 8 patients showing relief of obstruction.
- Two patients required secondary nephrectomy due to severely impaired renal function.
Conclusions:
- Ureterocalyceal anastomosis remains a viable option for specific challenging pediatric urological conditions.
- Careful patient selection is crucial for achieving excellent functional results.
- Nephrectomy is a necessary consideration in cases with significant renal impairment where salvage is not feasible.
Objective:
We report our experience with ureterocalyceal anastomosis in children regarding indications and outcome.
Materials And Methods:
A retrospective review was performed of all cases that underwent open ureterocalyceal anastomosis at our center between 2000 and 2006. Records were reviewed for patient age, history, affected side, indication of surgery and operative details. Clinical and radiological outcome was assessed. Success was defined as both symptomatic relief and radiographic resolution of obstruction at last follow up.
Results:
There were 10 cases (six males, four females) with a mean age of 6.5 years (range 3-13 years). Follow up ranged from 6 to 46 months (mean 18). The indications for surgery were failed pyeloplasty in six patients and iatrogenic injury of the ureteropelvic junction or the upper ureter in four. No significant perioperative complications were encountered in the study group. Overall success rate was 80%. Relief of obstruction was evident in eight patients as documented by intravenous urography or nuclear renography, while secondary nephrectomy was necessitated in two patients with severely impaired ipsilateral renal function and normal contralateral kidney. In patients with preserved renal units, the differential function on the involved side was stable on comparing the preoperative and postoperative renographic clearance (26 vs 24 ml/min).
Conclusion:
Ureterocalyceal anastomosis in children is still indicated in some difficult situations. Excellent functional results can be achieved in properly selected cases. Nephrectomy may be indicated in cases with impaired renal function and inability to perform salvage procedure.
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