To present a novel ureteric re-implantation technique for primary obstructed megaureter (POM) that ensures success in the short- and long-term, as conventional techniques are not ideal for megaureters especially in children, with ureteric stenosis and reflux being common complications after re-implantation.
Between 2009 and 2012, 22 paediatric patients with POM were enrolled. We performed a new technique for re-implantation of these ureters to ensure minimal incidence of ureteric strictures and easy subsequent endoscopic access. We performed follow-up voiding cystourethrography (VCUG) at 6 months postoperatively.
The cohort comprised 14 boys and eight girls, with a median age of 22 months. Six patients underwent bilateral re-implantation. The mean (range) duration of indwelling ureteric catheterisation was 7.8 (4-14) days. There were no complications in the perioperative and postoperative periods. There was no reflux on follow-up VCUG in any of the patients. One patient developed Grade I reflux after 1 year and presented with a urinary tract infection. Diagnostic cystoscopy was performed in 13 patients showing that the nipple was directed similarly to the native ureteric orifice.
The embedded-nipple technique for re-implantation of POM guarantees successful results and permits easy subsequent ureteroscopic access when needed.
Arab journal of urology. 2016 May 20*** epublish ***
Tamer M Abou Youssif, Ahmed Fahmy, Hazem Rashad, Mohammed Adel Atta
Department of Urology, Faculty of Medicine, Alexandria University, Alexandria, Egypt., Department of Urology, Faculty of Medicine, Alexandria University, Alexandria, Egypt., Department of Urology, Faculty of Medicine, Alexandria University, Alexandria, Egypt., Department of Urology, Faculty of Medicine, Alexandria University, Alexandria, Egypt.