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Technical Modification of the Terminal Ureter During Total Transperitoneal Laparoscopic Nephroureterectomy for Upper Urinary Tract Urothelial Carcinoma
06:39

Technical Modification of the Terminal Ureter During Total Transperitoneal Laparoscopic Nephroureterectomy for Upper Urinary Tract Urothelial Carcinoma

Published on: November 22, 2019

A modified technique for ureteral reimplantation: intravesical detrusorrhaphy

Kwang Hyun Kim1, Yong Seung Lee, Young Jae Im

  • 1Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul 120-752, Korea.

Journal of Pediatric Surgery
|August 13, 2013
PubMed

Insights

Intravesical detrusorrhaphy, a modified ureteral reimplantation, effectively treats vesicoureteral reflux (VUR) and obstructive megaureter (OM). This technique shows high success rates and avoids postoperative urinary retention in bilateral cases.

Area of Science:

  • Pediatric Urology
  • Surgical Techniques
  • Urology

Background:

  • Vesicoureteral reflux (VUR) and obstructive megaureter (OM) are common pediatric urological conditions.
  • Traditional ureteral reimplantation techniques can have associated complications.

Purpose of the Study:

  • To describe the surgical procedure of intravesical detrusorrhaphy.
  • To report initial clinical experience with this modified ureteral reimplantation technique.

Main Methods:

  • An open intravesical approach was used for intravesical detrusorrhaphy.
  • The technique involves creating a submucosal tunnel by repairing the detrusor underneath the mobilized ureter.
  • The ureteral orifice is anastomosed to its orthotopic position.

Main Results:

  • The study included 55 children with VUR and 13 with OM.
  • Success rates for VUR resolution were 91.1% (68/72 ureters).
  • Improvement rates for OM were 84.6% (11/13 patients, 12/14 ureters).
  • No postoperative urinary retention occurred in bilateral cases.

Conclusions:

  • Intravesical detrusorrhaphy is a safe and effective modified ureteral reimplantation technique.
  • It successfully recreates the neo-ureteric orifice in the orthotopic position.
  • The procedure is well-tolerated, with no reported urinary retention in bilateral procedures.
Abstract

Keywords:
ReplantationUreterUrinary bladderVesico-ureteral reflux

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