Reconstructive surgery for lower pole ureteropelvic junction obstruction associated with incomplete ureteral duplication
| Autor: | Richard C. Rink, Kirstan K. Meldrum, David Gilley, Mark P. Cain, Brian A. VanderBrink |
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| Rok vydání: | 2009 |
| Předmět: |
Male
Reconstructive surgery medicine.medical_specialty Pyeloplasty Adolescent Urology medicine.medical_treatment Ureteropelvic junction Duplex Kidney Ureter medicine Humans Kidney Pelvis Retrospective Studies business.industry Lower pole Infant Surgery medicine.anatomical_structure Ureteral duplication Child Preschool Pediatrics Perinatology and Child Health Urologic Surgical Procedures Female Presentation (obstetrics) business Ureteral Obstruction |
| Zdroj: | Journal of Pediatric Urology. 5:374-377 |
| ISSN: | 1477-5131 |
| DOI: | 10.1016/j.jpurol.2009.02.205 |
| Popis: | Introduction The lower moiety of duplex kidney can be associated with ureteropelvic junction obstruction (UPJO). Surgical correction can be challenging in cases of incomplete duplication where the junction of the lower and upper pole ureters is proximal. We review our experience with this unusual entity with an emphasis on surgical techniques employed in reconstruction. Methods We retrospectively reviewed the charts of eight patients with lower pole UPJO who underwent surgery in 2002–2008. The surgical approach, specifically the utilization of the non-obstructed upper pole ureter, used in the reconstruction was noted. Results Four of eight patients were symptomatic at presentation with either infection or pain. UPJO was at least in part secondary to lower pole crossing vessels in four patients and was treated with dismembered pyeloplasty. Lower pole to upper pole pyeloureterostomy was necessary in four patients due to short ureteral length between the UPJ and junction of lower and upper pole ureters. No complications or obstruction of either moiety developed during 1 year of follow up. Conclusions Lower pole UPJO in incomplete renal duplication mandates individualized surgical treatment dependent upon anatomy encountered. We have found that pyeloureterostomy is a safe alternative to drainage of the obstructed lower pole. |
| Databáze: | OpenAIRE |
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