Surgery for duplex kidneys with ectopic ureters: ipsilateral ureteroureterostomy versus polar nephrectomy.
Publication/Presentation Date
8-1-1989
Abstract
Conventional surgery for the ectopic ureter stresses polar nephrectomy, while preserving a functioning upper pole by ipsilateral ureteroureterostomy is performed less commonly. During the last 15 years we operated on 35 children for ectopic ureter. High ipsilateral ureteroureterostomy (15 patients) was performed when the upper pole cortex appeared to be smooth and pink, and the anastomosis was surgically feasible. Upper pole nephrectomy and upper ureterectomy (21 patients) were performed when the involved segment appeared grossly to be pale, cystic or otherwise abnormal. One low ipsilateral ureteroureterostomy was performed concomitant with contralateral ureteral reimplantation. Complications after ipsilateral ureteroureterostomy and partial nephrectomy were similar. Histological evidence of dysplasia of the polar nephrectomy specimens was focal in 7 patients (33 per cent), marked in 2 (10 per cent) and not detected in 12 (57 per cent). Ipsilateral ureteroureterostomy is an appropriate means to manage the ectopic ureter in selected cases because dysplasia in these upper pole renal units seldom is significant, and because ipsilateral ureteroureterostomy and polar nephrectomy have similar postoperative morbidity rates.
Volume
142
Issue
2 Pt 2
First Page
532
Last Page
534
ISSN
0022-5347
Published In/Presented At
Smith, F. L., Ritchie, E. L., Maizels, M., Zaontz, M. R., Hsueh, W., Kaplan, W. E., & Firlit, C. F. (1989). Surgery for duplex kidneys with ectopic ureters: ipsilateral ureteroureterostomy versus polar nephrectomy. The Journal of urology, 142(2 Pt 2), 532–543. https://doi.org/10.1016/s0022-5347(17)38806-7
Disciplines
Medicine and Health Sciences
PubMedID
2746774
Department(s)
Department of Surgery
Document Type
Article