Endoureterotomy for Congenital Primary Obstructive Megaureter: Preliminary Report

Bapat, S.; Bapat, Milind; Kirpekar, Deepak

doi:10.1089/end.2000.14.263

Cited by 19 publications

(9 citation statements)

References 10 publications

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“…The occurrence of reflux at 12 months after treatment in a patient who presented with an obstructive megaureter was similar to the findings in the literature and did not have any clinical impact. [10][11][12][13] In our study, the 4 cases of stenosis of the ureteral meatus that we treated were secondary, similar Strup and colleagues' results 12 on the endoscopic treatment of bladder pathology. In their study, 7 patients were treated with a transureteral and percutaneous approach using an incision with scissors or a ureterotome.…”

Section: Discussionsupporting

confidence: 87%

“…When reflux is present after endoscopic treatment, this condition is typically low grade and disappears within months in most patients. [8][9][10][11] The endoscopic incision is typically performed at the 6 o'clock or at 6 and 12 o'clock positions; 8,10 however, we performed the incision at the 5 o'clock position in the right ureter and at the 7 o'clock position in the left ureter. The occurrence of reflux at 12 months after treatment in a patient who presented with an obstructive megaureter was similar to the findings in the literature and did not have any clinical impact.…”

Section: Discussionmentioning

confidence: 99%

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Endoscopic treatment of ureterovesical junction obstructive pathology: A description of the oblique meatotomy technique and results

Arrabal‐Martín¹,

Zuluaga-Gomez²,

Merino‐Salas³

et al. 2013

CUAJ

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original research E728Cite as: Can Urol Assoc J 2013;7(11-12):e728-31. http://dx.doi.org/10.5489/cuaj.496 Published online November 8, 2013. AbstractBackground: Benign obstructive pathology of the ureterovesical junction includes congenital and acquired illnesses. The objective of this study was to describe the endoscopic oblique meatotomy technique using scissors and cold cutting to treat benign obstructive pathology of the ureterovesical junction. Methods: From 2007 to 2012, we treated 18 patients with obstructive pathology of the ureterovesical junction (5 megaureters [3 with lithiasis], 4 iatrogenic stenoses, and 9 ureteroceles with lithiasis). In all cases, oblique meatotomy was performed using endoscopic scissors through an 8.5 Ch ureteroscope. The mean follow-up for all patients was 3 years. Pain, grade of hydronephrosis, and occurrence of vesicoureteral reflux were evaluated before and after treatment. Results: The mean endoscopic treatment time was 13.4 minutes. The procedure was performed on an outpatient basis with 6 hours of hospital admission, and a double J stent was inserted for 6 weeks. We achieved treatment success in 94.5% of patients after 3 years of follow-up. Only 1 patient presented with vesicoureteral reflux at 12 months after treatment; however, this condition did not require further treatment. Overall, 100% of patients remained free from lithiasis. There are 2 main limitations: the small number of patients and the lack of another group to compare the results of this technique; however, the aim of this work was to communicate a new technique to treat ureterovesical junction stricture Interpretation: Oblique ureteral meatotomy is a safe and effective treatment for benign obstructive pathology of the ureterovesical junction and has a low index of complications.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Endoscopic treatment of ureterovesical junction obstructive pathology: A description of the oblique meatotomy technique and results

Arrabal‐Martín¹,

Zuluaga-Gomez²,

Merino‐Salas³

et al. 2013

CUAJ

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“…One method to achieve internal drainage in megaureters is endoscopic incision of the narrowed ureteral segment. 13 Lee et al 5 have recently attempted creation of a refluxing ureteral reimplantation as a temporizing measure in 3 infants with a severe PNRM and significant function deterioration. Both procedures work by exchanging VUJ obstruction for the less harmful VUR and unavoidably commit the child to secondary bladder reconstruction.…”

Section: Modifications In Hydronephrosis (Ace) and Ureteral Dilatiomentioning

confidence: 99%

Double-J stent insertion across vesicoureteral junction—is it a valuable initial approach in neonates and infants with severe primary nonrefluxing megaureter?

Castagnetti

Cimador

Sergio

et al. 2006

Urology

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“…Although transurethral endoscopic laser or electronic ureteral resection provided good short-term results, further observation of its long-term effects are needed. [6], [7] In recent years, laparoscopic ureteral reimplantation has been widely recommended in the treatment of congenital megaureter as a minimally invasive therapy. Pure laparoscopic reconstructive surgery requires extensive experience in laparoscopic surgery.…”

Section: Discussionmentioning

confidence: 99%

Pure Laparoscopic and Robot-Assisted Laparoscopic Reconstructive Surgery in Congenital Megaureter: A Single Institution Experience

Zhang

et al. 2014

PLoS ONE

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To report our experience of pure laparoscopic and robot-assisted laparoscopic reconstructive surgery in congenital megaureter, seven patients (one bilateral) with symptomatic congenital megaureter underwent pure laparoscopic or robot-assisted laparoscopic surgery. The megaureter was exposed at the level of the blood vessel and was isolated to the bladder narrow area. Extreme ureter trim and submucosal tunnel encapsulation or papillary implantations and anti-reflux ureter bladder anastomosis were performed intraperitoneally by pure laparoscopic or robot-assisted laparoscopic surgery. The clinical data of seven patients after operation were analyzed, including the operation time, intraoperative complications, intraoperative bleeding volumes, postoperative complications, postoperative hospitalization time and pathological results. All of the patients were followed. The operation was successfully performed in seven patients. The mean operation times for pure laparoscopic surgery and robotic-assistant laparoscopic surgery were 175 (range: 150–220) and 187 (range: 170–205) min, respectively, and the mean operative blood loss volumes were 20 (range: 10–30) and 28.75 (range: 15–20) ml, respectively. There were no intraoperative complications. The postoperative drainage time was 5 (range: 4–6) and 5.75 (range: 5–6) d, respectively, and the indwelling catheter time was 6.33 (range: 4–8) d and 7 (range: 7–7) d, respectively. The postoperative hospitalization time was 7.67 (range: 7–8) d and 8 (range: 7–10) d, respectively. There was no obvious pain, no secondary bleeding and no urine leakage after the operation. Postoperative pathology reports revealed chronic urothelial mucosa inflammation. The follow-up results confirmed that all patients were relieved of their symptoms. Both pure laparoscopic and robot-assisted laparoscopic surgery using different anti-reflux ureter bladder anastomoses are safe and effective approaches in the minimally invasive treatment of congenital megaureter.

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Endoureterotomy for Congenital Primary Obstructive Megaureter: Preliminary Report

Abstract: Although our series is small and follow- up is relatively short, it appears that endoureterotomy is a safe and effective treatment for COMU.

Cited by 19 publications

References 10 publications

Endoscopic treatment of ureterovesical junction obstructive pathology: A description of the oblique meatotomy technique and results

Endoscopic treatment of ureterovesical junction obstructive pathology: A description of the oblique meatotomy technique and results

Double-J stent insertion across vesicoureteral junction—is it a valuable initial approach in neonates and infants with severe primary nonrefluxing megaureter?

Pure Laparoscopic and Robot-Assisted Laparoscopic Reconstructive Surgery in Congenital Megaureter: A Single Institution Experience

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