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A Murine Model of Irreversible and Reversible Unilateral Ureteric Obstruction
Published on: December 20, 2014
28 years of functioning of the ileal ureter - own experience and systematic review
T Koszutski1, D Smyczek Krakowczyk1, A Pastuszka1
1Upper Silesian Child Health Center in Katowice, Silesian University of Medicine, Pediatric Surgery and Urological Department, Katowice, Poland.
Insights
Ileal ureteral reconstruction is a safe and effective option for children with ureteral damage, preserving kidney and bladder function long-term. This study reviewed 75 pediatric cases and a long-term patient case, confirming its therapeutic value.
Area of Science:
- Pediatric Urology
- Surgical Reconstruction
- Renal Function Preservation
Background:
- Ureteral damage in children presents significant challenges, with limited reconstructive options.
- Ileal replacement (ileal ureter) is a viable surgical strategy for ureteral reconstruction.
- Few studies examine long-term outcomes of ileal ureters, especially in solitary kidneys.
Observation:
- A systematic review analyzed 75 pediatric cases of ureteral substitution using ileal segments.
- A case report details a 29-year-old female with a solitary kidney who underwent ileal ureter replacement at 14 months old.
- The review followed PRISMA guidelines, searching PubMed and Scopus.
Findings:
- Ureteral substitution with ileal segments yielded satisfactory and acceptable outcomes in pediatric cases.
- The long-term follow-up of the presented case demonstrated the procedure's efficacy.
- Ileal ureteral reconstruction is effective even in solitary kidney scenarios.
Implications:
- Ileal ureteral reconstruction is a safe and effective long-term therapeutic option.
- This technique aids in preserving both renal and bladder function.
- It offers a solution for social continence in pediatric patients with complex ureteral issues.
A Short Introduction:
Irreversible ureteral damage is a rare and challenging problem for pediatric urologists. Ileal replacement has become one of the limited surgical options for ureteral reconstruction. Only a few papers have examined the results of the ileal ureter and renal function outcomes. Furthermore, there are even fewer papers showing patients with the intestinal ureter, which is used to drain urine from a solitary kidney in early childhood.
An Objective:
To perform a systematic review and analyze available cases of the long-term function of the "neoureter" and differences in the surgical approach. To present the case of a 29-year-old female with a history of ileal replacement of the ureter in a solitary kidney which was performed in this patient at the age of 14 months.
Study Design:
PubMed and Scopus were used to search for eligible articles. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were strictly followed. Based on the titles, abstracts, and full-text reviews, 77 articles were analyzed, of which only 23 were directly related to pediatric cases of our interest. Medical records of the female patient, who has been treated in our center since 1991, were retrospectively described and reviewed.
Results:
Of 23 papers, we identified 75 cases of children who underwent ureteral substitution. The outcomes of the procedure are satisfactory and acceptable. The presented case of the female patient shows a good therapeutic option.
Conclusion:
Ileal ureteral reconstruction is a safe and effective therapeutic option (even in a long-term follow-up). Despite many problems and complications, it allows preservation of renal and bladder function and social dryness.
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