Comparison of 2 Different Tapering Techniques in Megaureters

Laparoscopic Reconstruction for Obstructive Megaureter: Single Institution Experience with Short- and Intermediate-Term Outcomes

“…Although both plication and excisional tapering have been practiced to achieve reduction of the ureteral caliber, excisional tailoring outscores in the presence of grossly dilated ( > 1.75 cm) and thick ureters. 11 In our series, all pathologic units were grossly dilated, and hence we followed this exercise universally.…”

Long-Term Outcome Analysis of Starr Plication for Primary Obstructive Megaureters

“…The only direct comparison between ureteral folding and excisional tapering was done in a small study in a minipig model. 2 The folding technique was deemed superior due to better preservation of the ureteral blood supply. Excisional ureteral tailoring is complicated by a low but significant rate of postoperative stricture and obstruction, which is again thought to be secondary to injury to the delicate ureteral vasculature.…”

Endoureterotomy for Treatment of Primary Obstructive Megaureter in Children

“…5,18 The complications of the classic methods are well known, with rates ranging from 4% to 25% in different series. 5,[19][20][21][22][23][24] An important complication of both techniques is stricture secondary to damage to the thin and fragile ureteral vessels. 25 Strictures also may follow plication techniques, probably because of compression of the vessels by the folded wall.…”

“…25 Strictures also may follow plication techniques, probably because of compression of the vessels by the folded wall. 22 Moreover, open surgery is associated with a high degree of invasiveness, morbidity, higher cost, creation of VUR, and even death. Therefore, there is a tendency to avoid open surgical procedures as first-line treatment for ureteral obstruction.…”

“…Interestingly, our success rate equals or exceeds the cure rates achieved by open surgery. 5,[19][20][21][22][23][24] Besides, the costs are reduced prominently compared with open surgery.…”