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https://www.readbyqxmd.com/read/28476680/an-inguinal-approach-to-complex-extravesical-ureteral-reimplantation
#1
Adam S Howe, Lane S Palmer
OBJECTIVE: To report our experience in applying the Lich-Gregoir extravesical ureteral reimplantation (EVR) approach to complex cases (megaureter, duplex systems) through a small inguinal incision, with the goal of minimizing invasiveness. MATERIALS & METHODS: We reviewed the records of all patients who underwent common sheath and/or tapered EVR through an inguinal incision. Patient characteristics and reflux grade were obtained, and outcomes were assessed. The technique involved a 2 cm incision made in the lowest inguinal skin crease, standard cord exposure and lateral retraction, opening the floor of the canal to isolate the ureter...
May 2, 2017: Urology
https://www.readbyqxmd.com/read/28417852/nuclear-medicine-in-pediatric-nephro-urology-an-overview
#2
REVIEW
Iosif Mendichovszky, Bernardita Troncoso Solar, Naima Smeulders, Marina Easty, Lorenzo Biassoni
In the context of ante-natally diagnosed hydronephrosis, the vast majority of children with a dilated renal pelvis do not need any surgical treatment, as the dilatation resolves spontaneously with time. Slow drainage demonstrated at Tc-99m-mercaptoacetyltriglycine (MAG3) renography does not necessarily mean obstruction. Obstruction is defined as resistance to urinary outflow with urinary stasis at the level of the pelvic-ureteric junction (PUJ) which, if left untreated, will damage the kidney. Unfortunately this definition is retrospective and not clinically helpful...
May 2017: Seminars in Nuclear Medicine
https://www.readbyqxmd.com/read/28333838/wilms-tumor-extension-into-duplex-ureter-in-a-10-year-old-girl
#3
İbrahim Karnak, Mithat Haliloğlu, Diclehan Orhan, Tezer Kutluk
Ureteral extension of Wilms tumor (WT) is a rare occasion. The association of duplex collecting system and WT is extremely rare. Ureteral extension of WT in a duplex collecting system is an unreported entity to date. A 10-year-old girl presenting with WT extending into upper pole ureter of duplex system is reported to emphasize the importance of preoperative diagnosis to plan step by step surgery in this rare coincidental situation.
April 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28216451/ureteric-obstruction-from-malignant-melanoma-in-both-right-double-moiety-and-left-single-moiety-ureters
#4
Brayden March, Ross John Spero Calopedos, Edward Latif, Rupert Ouyang
We report the first documented case of malignant melanoma obstructing ureters of both moieties of a duplex kidney and contralateral single moiety ureter in a 51-year-old male. The patient presented with fever, coryzal symptoms, and liver function test derangement several years after 2 superficial spreading melanomas were excised with clear margins. Ultrasonography demonstrated hydronephroureter in both moieties of a complete right-sided duplex kidney. Retrograde pyelograms showed bilateral hydronephroureter and filling defects in all 3 ureters...
February 16, 2017: Urology
https://www.readbyqxmd.com/read/28167691/robotic-partial-nephrectomy-for-duplex-kidney-with-ectopic-ureter-draining-in-the-vagina-in-an-adult-patient-with-urinary-incontinence
#5
Humza Mahmood, Marios Hadjipavlou, Raj Das, Chris Anderson
A duplex kidney system with an ectopic ureter draining into the vagina is a congenital malformation that typically presents as refractory urinary incontinence. Diagnosis is often difficult to establish and delayed due to a low incidence. We present the case of a patient aged 26 years with a life-long history of persistent urinary incontinence. Initial presentation was at childhood; however, the diagnosis went undetermined for 22 years. CT urography revealed a duplex kidney with an atrophic upper pole associated with an ectopic ureter that drained into the vaginal vault...
February 6, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28153776/robot-assisted-laparoscopic-pyeloureterostomy-in-infants-with-duplex-systems-and-upper-pole-hydronephrosis-variations-in-double-j-ureteral-stenting-techniques
#6
Minki Baek, Jason Au, Gene O Huang, Chester J Koh
OBJECTIVE: We describe our experience with robot-assisted laparoscopic (RAL) pyeloureterostomy in infants with duplex systems and upper pole hydronephrosis with an emphasis on the various double J (DJ) ureteral stent placement techniques. METHODS: We used our RAL pyeloureterostomy technique in two female infants with duplex systems and upper pole hydronephrosis. For case 1, we introduced the DJ stent and placed it in the recipient lower pole ureter during the robotic operation in an antegrade fashion...
January 19, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28130103/multi-institutional-review-of-outcomes-and-complications-of-robot-assisted-laparoscopic-extravesical-ureteral-reimplantation-for-treatment-of-primary-vesicoureteral-reflux-in-children
#7
William R Boysen, Jonathan S Ellison, Christina Kim, Chester J Koh, Paul Noh, Benjamin Whittam, Blake Palmer, Aseem Shukla, Andrew Kirsch, Mohan S Gundeti
PURPOSE: Robot-assisted laparoscopic extravesical ureteral reimplantation has been proposed as a minimally invasive alternative to open ureteral reimplantation for correcting primary vesicoureteral reflux in children. However, in the current literature there are conflicting data regarding the safety and efficacy of this approach. Amid ongoing debate we analyzed outcomes and complications from this procedure in a large multi-institutional cohort. MATERIALS AND METHODS: We reviewed the records of children who underwent robot-assisted laparoscopic extravesical ureteral reimplantation at 9 academic centers from 2005 to 2014...
June 2017: Journal of Urology
https://www.readbyqxmd.com/read/28126394/laparoscopic-selective-clipping-of-upper-moiety-vasculature-and-ureter-without-partial-nephrectomy-a-novel-technique-for-pediatric-urinary-incontinence-due-to-ectopic-ureter-associated-with-poor-functioning-upper-renal-moiety
#8
S H Hosseini Sharifi, B Nabavizadeh, S Mozafarpour, A-M Kajbafzadeh
OBJECTIVE: The aim of this study was to present a novel laparoscopic technique for persistent urinary incontinence in pediatrics due to ectopic ureter associated with poor functioning upper renal moiety. METHODS: This technique consisted of laparoscopic clipping of the upper moiety artery and vein. The ectopic ureter was also clipped afterwards without upper pole partial nephrectomy. RESULTS: The patient was a seven-year-old girl with persistent urinary incontinence and confirmation of duplex kidney with poor functioning upper moiety in pre-operative investigations...
January 13, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/27964829/the-role-of-voiding-cystourethrography-in-asymptomatic-unilateral-isolated-ureteropelvic-junction-obstruction-a-retrospective-study
#9
Mohammed S ElSheemy, Waleed Ghoneima, Mohammad Abdelwahhab, Waseem Aboulela, Kareem Daw, Ahmed M Shouman, Ahmed I Shoukry, Mohamed El Ghoneimy, Hany A Morsi, Hesham Badawy
INTRODUCTION: The presence of concomitant vesicoureteric reflux (VUR) and ureteropelvic junction obstruction (UPJO) is uncommon. Nevertheless, the reported VUR coexisting with asymptomatic unilateral isolated hydronephrosis (AUIH) requiring pyeloplasty for correction of UPJO was of low grade and mostly resolved during conservative follow-up. Therefore, VCUG may be not indicated in these children except if voiding symptoms, urinary tract infection (UTI), dilated ureters, or bladder and ureteric abnormalities are suspected...
November 24, 2016: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/27923152/hydronephrosis-in-the-wnt5a-ablated-kidney-is-caused-by-an-abnormal-ureter-bladder-connection
#10
Kangsun Yun, Alan O Perantoni
The Wnt5a null mouse is a complex developmental model which, among its several posterior-localized axis defects, exhibits multiple kidney phenotypes, including duplex kidney and loss of the medullary zone. We previously reported that ablation of Wnt5a in nascent mesoderm causes duplex kidney formation as a result of aberrant development of the nephric duct and abnormal extension of intermediate mesoderm. However, these mice also display a loss of the medullary region late in gestation. We have now genetically isolated duplex kidney formation from the medullary defect by specifically targeting the progenitors for both the ureteric bud and metanephric mesenchyme...
March 2017: Differentiation; Research in Biological Diversity
https://www.readbyqxmd.com/read/27919138/-modified-toyoda-method-for-complete-duplex-ureters-in-tubeless-cutaneous-ureterostomy-report-of-a-case
#11
Chul Jang Kim, Ryo Fujiwara, Hiroto Yamashita
A 65-year-old man underwent radical cystectomy and cutaneous ureterostomy for bladder cancer. Because the patient had left complete duplex ureters,we modified the Toyoda method to construct the tubeless cutaneous ureterostomy with a unilateral stomal creation. The adhesive portion of both ureteral walls in duplex ureters was simultaneously cut approximately 5 mm from the distal end longitudinally,and the common sheath of the cut portion of the ureters was cut approximately 5 mm longitudinally in order to separate the two ureters...
November 2016: Hinyokika Kiyo. Acta Urologica Japonica
https://www.readbyqxmd.com/read/27867847/retroperitoneal-and-laparoscopic-heminephrectomy-in-duplex-kidney-in-infants-and-children
#12
Ciro Esposito, Maria Escolino, Marco Castagnetti, Antonio Savanelli, Angela La Manna, Alessandra Farina, Francesco Turrà, Agnese Roberti, Alessandro Settimi, Francois Varlet, Holger Till, Jean Stephan Valla
BACKGROUND: Two main techniques are adopted to perform partial nephrectomy in children: laparoscopy and retroperitoneoscopy. The aim of this paper is to review the larger multicentric experience recently published by our group to review indications, techniques and results of both approaches. METHODS: Data of 102 patients underwent partial nephrectomy in a 5-year period using minimally invasive surgery (MIS) procedures were analyzed. Fifty-two children underwent laparoscopic partial nephrectomy (LPN), and 50 children underwent retroperitoneoscopic partial nephrectomy (RPN)...
October 2016: Translational pediatrics
https://www.readbyqxmd.com/read/27843217/robot-assisted-pyeloplasty-for-pelvi-ureteric-junction-obstruction-of-lower-moiety-in-partial-duplex-system-a-technical-challenge
#13
Girdhar S Bora, Kalpesh Parmar, Ravimohan S Mavuduru
Management of pelvi-ureteric junction obstruction (PUJO) in a duplex system is technically challenging as dissection at the pelvis may jeopardize the vascularity of the normal moiety ureter. Anastomosing the pelvis to the one single ureter will have a risk of future development of stricture which then will risk both the moieties. Robotic assistance enables appropriate tissue dissection; minimal handling of normal ureter and precision in suturing, overcoming the potential challenges involved in the minimally invasive management of such complex cases...
October 2016: Indian Journal of Urology: IJU: Journal of the Urological Society of India
https://www.readbyqxmd.com/read/27790549/ureteral-reflux-into-an-ectopic-upper-moeity-of-a-duplex-kidney-from-the-bladder-neck-with-distal-ureteral-pseudodiverticulum-formation
#14
Denver Steven Pinto, Tom George, Deepali Saxena, Thara Joseph, V Ravi Hoisala
Urinary incontinence is a condition causing significant psychological trauma and affects the quality of life of the affected individual. Though common causes of urinary incontinence of non-traumatic aetiology in young adults include detrusor instability and congenital conditions like meningomyelocoele, an ectopic ureter is an important surgically correctable cause of urinary incontinence. The cause of incontinence in an ectopic ureter is insertion of the ureter distal to the internal urethral sphincter. The authors describe a case report of an ectopic ureter arising from a duplex moiety with poor renal function using multiple modalities...
September 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27697471/utility-of-retrograde-ureterocelogram-in-management-of-complex-ureterocele
#15
M K Arevalo, J C Prieto, N Cost, G Nuss, B J Brown, L A Baker
INTRODUCTION: Symptomatic pediatric ureterocele has diverse manifestations, making evidence-based management impractical. Thus, detailed visualization of ureterocele anatomy prior to first surgical incision is invaluable. Retrograde ureterocelogram (RUC) is a simple, underutilized radiologic technique that can be performed during cystoscopy. This study sought to determine whether RUC changes surgical management by more accurately depicting the complex ureteral and ureterocele anatomy, compared with renal ultrasound (US) and voiding cystourethrography (VCUG)...
February 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/27695208/comparison-of-intravenous-urography-and-magnetic-resonance-urography-in-preoperative-evaluation-of-pelvi-ureteric-junction-obstruction-in-children
#16
Alok Sharma, Kushaljit Singh Sodhi, Akshay Kumar Saxena, Anmol Bhatia, Prema Menon, Katragadda L N Rao, Niranjan Khandelwal
AIMS: To compare intravenous urography (IVU) and magnetic resonance urography (MRU) in the preoperative evaluation of pelvi-ureteric junction obstruction (PUJO) in children. MATERIALS AND METHODS: A total of 35 children up to 10 years of age in whom unilateral or bilateral PUJO were suspected on ultrasonography were enrolled in this prospective study. All children underwent IVU and MRU, and the findings were compared. RESULTS: Of the 70 kidneys evaluated, 14 (20%) were not visualized on IVU because of nonexcretion of contrast, whereas all the 70 (100%) kidneys were visualized on MRU...
October 2016: Journal of Indian Association of Pediatric Surgeons
https://www.readbyqxmd.com/read/27545957/the-morphology-and-treatment-of-coexisting-ureteropelvic-junction-obstruction-in-lower-moiety-of-duplex-kidney
#17
Wei Liu, Liujuan Zhang, Rui Ma, Rongde Wu
BACKGROUND: Duplex kidney is a common congenital anomaly of the urinary tract, while ureteropelvic junction obstruction (UPJO) in lower unit of duplex kidney is rare. Surgical treatment can be challenging in such cases. The aim was to report our experience in managements of UPJO in lower moiety of duplex kidney. METHODS: Among the pediatric patients with duplex system from 2007 to 2013, 7 children were diagnosed with UPJO in lower moiety. Their medical records were retrospectively analyzed, mainly focused on anatomic aspects and operation details...
October 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27542552/innovation-in-robotics-and-pediatric-urology-robotic-ureteroureterostomy-for-duplex-systems-with-ureteral-ectopia
#18
Michael J Biles, Julia B Finkelstein, Mark V Silva, Sarah M Lambert, Pasquale Casale
INTRODUCTION: Robotic technology has been increasingly utilized for complicated reconstructive surgeries in pediatric urology, such as ureteroureterostomy (UU). The literature is limited regarding the performance of minimally invasive UU in children, and the existing published series utilize indwelling ureteral stents. We sought to report on our pediatric experience with robot-assisted laparoscopic (RAL)-UU using a temporary ureteral catheter in duplex systems with ureteral ectopia. METHODS: A retrospective chart review was performed of all pediatric patients who underwent RAL-UU at a single institution over a 2-year period...
October 2016: Journal of Endourology
https://www.readbyqxmd.com/read/27121408/laparoscopic-psoas-hitch-double-ureteral-re-implantation-in-the-duplex-urinary-system-for-treatment-of-ureterovaginal-fistula
#19
Tito Palmela Leitão, Ricardo Pereira E Silva, Sónia Barata, Adalgisa Guerra, Filipa Osório
INTRODUCTION: Although laparoscopy is widely established for ablative urologic procedures, pelvic reconstructive procedures are still mostly performed by open-surgery. As urologists continue to introduce advanced laparoscopic skills to reconstructive urologic procedures, we present our experience with a laparoscopic psoas hitch double ureteral re-implantation in a patient with an ureterovaginal fistula and an ipsilateral duplex urinary system. MATERIALS AND METHODS: A 42-year-old patient presented with continuous involuntary urine loss from the vagina after an abdominal hysterectomy...
April 2016: Surgical Technology International
https://www.readbyqxmd.com/read/27117052/endoscopic-treatment-of-grades-iv-and-v-vesicoureteral-reflux-with-two-bulking-substances-dextranomer-hyaluronic-acid-copolymer-versus-polyacrylate-polyalcohol-copolymer-in-children
#20
COMPARATIVE STUDY
Canan Kocaoglu
PURPOSE: We aimed at evaluating the efficacy and complications of two bulking substances: dextranomer/hyaluronic acid copolymer(Dx/Ha;Dexell®) versus polyacrylate polyalcohol copolymer(PPC;Vantris®) in subureteric injection treatment of children with high grades (grades IV-V) vesicoureteral reflux(VUR). METHODS: Data of patients undergoing endoscopic treatment of high grade VUR (January 2009-August 2015) were retrospectively investigated. Patients with high grade VUR caused by posterior urethral valve, duplex system, paraureteral diverticula and neurogenic bladder were excluded...
October 2016: Journal of Pediatric Surgery
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