Laparoscopic Reimplantation for the Management of Ureteral Duplications With Primary Megaureters in Children

Abstract

Ureteral duplication is an abnormality of the urogenital tract, which may be presented in about 0,8% of the population. However, in some cases, a complete doubling of the collective system is combined with such defects as megaureter, ureterocele, vesicoureteral reflux, urinary incontinence, and others. Currently, there are several treatment options for children with urological pathology in the doubling of the kidneys. Depending on the type of pathology and the functional state of the affected segment, this can be both organ-bearing operations (heminephrouretherectomy), and reconstructive plastic interventions - ureterocystoneoimplantation of the one ureter or both ureters by a “single unit”, as well as the formation of inter-uterine anastomoses. In recent years, there was appeared the possibility to use endovideosurgical technologies for the reconstruction of the urinary tract. The article presents the experience of using laparoscopic reimplantation of the ureter in the correction of various variants of defects in doubling the upper urinary tract in children. But on the other hand, complete ureteral duplication can be detected in the association with ureter hydronephrosis, ureterocele, and ectopic ureters. Another common disease, which can coexist with duplication is vesicoureteral reflux (VUR).