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Updated: Jun 15, 2025
A Murine Model of Irreversible and Reversible Unilateral Ureteric Obstruction
Published on: December 20, 2014
Ureteroureterostomy as Definitive Intervention for Duplex Anomalies: A Mid-Term Analysis
Sahar Eftekharzadeh1, Aznive Aghababian2, Suhaib Abdulfattah2
1Department of Urology, Jefferson Einstein Medical Center, Philadelphia, PA; Division of Urology, Children's Hospital of Philadelphia, Philadelphia, PA.
Objective:
To provide a mid-term evaluation-defined as 3 to 10 years of post-operative follow up-of children with duplicated collecting systems undergoing ureteroureterostomy. In addition, a sub stratified analysis based on surgical approach is delivered to compare outcomes between the two approaches.
Materials And Methods:
An IRB-approved single-institutional registry was retrospectively reviewed to identify all patients undergoing ureteroureterostomy (UU) for duplex renal anomalies between 2014 and 2020. Only children with a minimum 3 years follow-up with available post-operative imaging were included in the study. Details including incidence of febrile UTI (f-UTI), flank pain, post-operative renal function, ultrasound findings, and need for further surgical intervention at follow-up were aggregated to assess mid-term outcomes.
Results:
During the study period, 78 patients underwent UU, 42/78 patients met the inclusion criteria: 36 robot-associated laparoscopic UU, and 6 open UU (OUU). OUU cohort was significantly younger (0.35 vs 2.5 years, P = .002). There was no statistical difference in procedure length between the 2 groups (180.5 vs 203.5 minutes, P = .68). Multivariate logistic regression demonstrated that constipation at the most recent follow-up was the only predictor of f-UTI (OR: 6.6, 95%CI 1.5-28.5, P = .01). Imaging at a median of 60 months post-operatively showed resolved, improved, or stable dilation of the operated moiety in 41 (98%) patients. De novo hydronephrosis of the recipient moiety was found in 3 (7%) patients at the most recent follow-up imaging, with UTD-P1 in 2 patients and UTD-P2 in 1 patient-likely secondary to intermittent constipation. Of these 3 patients, all were asymptomatic, and none experienced post-operative f-UTI.
Conclusions:
At mid-term follow-up, robot-associated laparoscopic UU and OUU are safe and effective approaches for management of duplicated collecting systems with obstruction or vesicoureteral reflux (VUR). Additionally, yo-yo reflux is uncommonly diagnosed and clinically irrelevant.
