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Ipsilateral ureteroureterostomy for single ureteral reflux or obstruction in a duplicate system
M Bieri1, C K Smith, A Y Smith
1Division of Urology, University of New Mexico Health Sciences Center, Albuquerque, USA.
Purpose:
The traditional treatment for obstruction or reflux involving a single ureter in a duplicated system has been common sheath reimplantation. More recently, ipsilateral ureteroureterostomy has been suggested as an alternative treatment. We reviewed cases with duplicate systems that were treated with ipsilateral ureteroureterostomy at our institution to determine the acceptability of this operation as an alternative to common sheath reimplantation.
Materials And Methods:
A total of 22 patients with 24 duplicate systems underwent ipsilateral ureteroureterostomy between March 1986 and December 1996. Patient charts were reviewed and analyzed for patient age, sex, ureteral and renal anatomy, initial presentation, the clinical situation necessitating operation, and the occurrence of early and late complications. Patients were followed for a mean period of 41.4 months.
Results:
Two adults and 20 children 10 years old or younger presented with urinary tract infection (13), hydronephrosis on maternal ultrasound (5), dribbling (2), ureteral calculus (1) and hydronephrosis on neonatal abdominal ultrasound (1). Mean hospital stay was 3 days. There was 1 early and 1 late complication.
Conclusions:
Ipsilateral ureteroureterostomy is an acceptable alternative to common sheath reimplantation in select patients with single ureteral disease in a duplicate system.