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Uretero-ureterostomy methods in ureteral duplication: Narrative review of the literature

M Keleş1, A Harun Kinik2, M Selçuk Silay3

  • 1Departamento de Urología, Facultad de Medicina, Universidad de Ordu, Ordu, Turkey.

Actas Urologicas Espanolas
|July 16, 2025
PubMed

Insights

Uretero-ureteral anastomosis (UUA) methods for duplicated renal systems in children show high success rates. Minimally invasive techniques offer shorter hospital stays, but more comparative studies are needed to determine the best approach for duplex systems.

Area of Science:

  • Pediatric Urology
  • Surgical Techniques
  • Renal System Anomalies

Background:

  • Duplicated renal systems are congenital anomalies requiring surgical intervention.
  • Uretero-ureteral anastomosis (UUA) is a surgical option for managing these systems.
  • Evaluating different UUA methods is crucial for optimizing pediatric surgical care.

Purpose of the Study:

  • To review and evaluate uretero-ureteral anastomosis (UUA) methods used in pediatric patients with duplicated renal systems.
  • To analyze surgical outcomes, including hospital stay, operative time, and complications.
  • To identify gaps in the literature regarding comparative effectiveness of UUA techniques.

Main Methods:

  • Narrative review of studies published between 1967 and 2024.
  • Inclusion criteria: pediatric patients (<18 years) undergoing UUA for double collecting systems.
  • Exclusion criteria: heminephrectomy, ureteral reimplantation, ureteral clipping.
  • Keywords used: 'double collecting system ureter ureteral anastomosis', 'duplex kidney ureter ureteral anastomosis', etc. in PubMed.

Main Results:

  • 29 studies involving UUA for duplicated renal systems were included.
  • No studies directly compared open, laparoscopic, and robot-assisted UUA.
  • Minimally invasive approaches (laparoscopic, robot-assisted) showed shorter hospital stays compared to open surgery.
  • Outcomes and complication rates were comparable across techniques, with similar operative times.

Conclusions:

  • All UUA operative approaches are feasible with high success and low complication rates.
  • Current literature is insufficient to definitively determine the superiority of open, laparoscopic, or robot-assisted UUA.
  • Prospective comparative studies are necessary to establish the most effective UUA method for pediatric duplex systems.
Abstract

Keywords:
Anastomosis ureteroureteralDoble sistema colectorDouble collecting systemDuplex kidneyDuplicated kidneyRiñón dobleRiñón duplicadoUreteroureteral anastomosis

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