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[Ureteropyelostomy for obstructed duplicated ureter an easy and reliable operation in infants]
A el Ghoneimi1, H Lottmann, E Odet
1Service de Chirurgie Pédiatrique, Hôpital Robert Debré, Paris.
Insights
Ureteropyelostomy is a safe and effective surgical option for treating obstructed duplicated ureters in infants diagnosed prenatally. This procedure offers a reliable method for managing upper pole ureter obstruction in young children.
Area of Science:
- Pediatric Urology
- Surgical Management
- Congenital Abnormalities
Background:
- Obstructed duplicated ureter is a common congenital anomaly in children.
- Prenatal diagnosis allows for early identification of urinary tract abnormalities.
- Ureteropyelostomy is a surgical technique used to address ureteral obstruction.
Purpose of the Study:
- To evaluate the efficacy and safety of ureteropyelostomy in young children with obstructed duplicated ureters.
- To assess outcomes in infants diagnosed prenatally with this condition.
Main Methods:
- Retrospective analysis of 11 children who underwent ureteropyelostomy between 1992 and 1996.
- Patients included those with prenatal diagnosis (7 cases) and acute pyelonephritis (4 cases).
- Mean age at surgery was 6 months; follow-up ranged from 6 months to 4 years.
Main Results:
- No postoperative complications were reported.
- Anastomoses did not require revision, and conserved segments maintained function.
- Three children required subsequent ureterovesical reimplantation due to reflux in the lower ureteral segment.
Conclusions:
- Ureteropyelostomy is a valuable surgical option for obstructed upper pole ureters diagnosed prenatally.
- Early management with ureteropyelostomy in infants can prevent septic complications.
- The procedure is technically straightforward and reliable for this patient group.
Aim:
Ureteropyelostomy is one of the surgical options to treat obstructed duplicated ureter. We retrospectively analysed the results of this procedure in a group of young children with prenatal diagnosis.
Material And Methods:
Between 1992 and 1996, 11 children underwent ureteropyelostomy for obstructed functioning duplicated ureter using the following procedures. 7 cases were revealed by prenatal ultrasound and 4 by acute pyelonephritis; an ureterocele was identified in 7 cases. The mean age at surgery was 6 months for the whole group (3-46 weeks), while in the subgroup of prenatal diagnosis, it was 8 weeks (3-9 weeks). The follow-up ranged from 6 months to 4 years.
Results:
There were no postoperative complications. None of the anastomoses needed revision, and the conserved segments maintained their functioning appearance, on follow-up. 3 children needed a subsequent ureterovesical reimplantation for urinary tract infections due to reflux in the lower segment ureter.
Discussion:
Ureteropyelostomy is of great interest for the management of the obstructed dilated upper pole ureter revealed by prenatal diagnosis. This specific group of children needs early management to avoid septic complications and ureteropyelostomy is an easy and reliable method at this young age.