[Long-term results in patients with double kidneys]

Area of Science:

• Pediatric Urology
• Congenital Anomalies
• Surgical Outcomes

Context:

• Duplex systems are common congenital anomalies of the upper urinary tract.
• Management of duplex systems presents challenges due to potential complications like reflux and obstruction.
• Surgical techniques and diagnostic accuracy have evolved over time.

Purpose:

• To evaluate surgical outcomes and complication rates in pediatric patients with duplex systems.
• To compare the efficacy of different surgical approaches for duplex systems.
• To identify factors influencing complication rates in duplex system management.

Summary:

• A retrospective analysis of 74 pediatric patients with duplex systems treated between 1971 and 1986.
• Patients were categorized into four groups based on duplex system type: bifid, complete duplication, duplication with ectopic ureter, and duplication with ureterocele.
• Complication rates decreased from 39% (1971-1978) to 20% (1979-1986), attributed to earlier diagnosis.
• Bifid systems and those with ectopic ureters had good outcomes, while ureteroceles remained associated with high complication rates.
• The cross-trigonal reimplant demonstrated superior results compared to the Politano-Leadbetter procedure.

Impact:

• Highlights the importance of early and accurate preoperative diagnosis in reducing complications associated with duplex systems.
• Provides evidence supporting the cross-trigonal reimplant as a preferred surgical technique for certain duplex system configurations.
• Informs clinical practice regarding the long-term management and prognosis of pediatric patients with various types of duplex systems.