New surgical method for one-stage total remodeling of massively dilated and tortuous ureter: tapering in situ...

During the past five years a surgical technique for extensive ureteral tailoring and preservation of its blood supply has been developed. Seventeen congenitally dilated and tortuous ureters were operated on. One-stage surgical remodeling involved excision of the ureteral kinks, total tapering from the ureterovesical to the ureteropelvic junctions, and ureteroneocystostomy. The rationale, technique, pitfalls, and results are discussed. In situ ureteral remodeling is indicated in massive ureteral dilatation and tortuosity, secondary operation following previous diversion or tailoring, and multiple obstructions in the same ureter. The success with these procedures suggests that one-stage surgical reconstruction in the most dilated and tortuous ureter, that would have been considered for skin exteriorization or multistaged tailoring can be accomplished safely with gratifying results.