184 / 330
184
28
TH
CONGRESS OF THE ESPU
14:54–14:57
S17-4 (PP)
THE FIRST LINE PSOAS HITCH BLADDER URETERAL
REIMPLANTATION IN CHILDREN UNDER 1-YEAR
Julien ROD
1
, Jean-Baptiste MARRET
1
, Henri LOTTMANN
2
, Marc-David LECLAIR
3
,
Sebastien FARAJ
3
, Anne DARIEL
3
, Yves AIGRAIN
2
, Thomas BLANC
2
and Philippe RAVASSE
1
1) Caen University Hospital, Department of Pediatric Surgery, Caen, FRANCE - 2) Necker Enfants Malades University
Children Hospital, Department of Pediatric Surgery and urology, Paris, FRANCE - 3) Children University Hospital,
Department of Pediatric Surgery, Nantes, FRANCE
PURPOSE
The surgical management of primary megaureter is controversial for children under 1-year, espe-
cially since the development of stenting or balloon dilatation. The aim of this study is to evaluate
the results of the psoas hitch bladder ureteral reimplantation as a primary procedure for congenital
megaureter in children under 1-year.
MATERIAL AND METHODS
Retrospective study in three centers between 1995 and 2015. Clinical and radiological characteris-
tics were collected of patients who underwent a psoas hitch ureteral reimplantation. The indications
were breakthrough UTI, decrease in function on renogram in single or duplex systems Patients
were followed up with clinical assessment and renal ultrasonography. According to the age at
surgery patients were divided in group 1 (children under 1 year, n=54) and group 2 (children over
1 year n=57). We assessed postoperative evolution of dilatation on ultrasound, rates of recurrent
UTIs, and need for redo surgery.
RESULTS
Mean age at surgery was 7,8 (group 1) and 31,7 (group 2) months. There were no significant
difference in indications for surgery between the two groups. No patients required re-operation
for anastomotic stricture or obstruction. The overall rate of postoperative breakthrough UTIs was
14,8% in group 1, vs 15,8% in group 2. Postoperative ultrasound showed an improvement of hydro-
nephrosis in 93% in the two groups.
When postop VCUG was systematically performed, it demonstrated post-reimplantation VUR in
18% in group 1 and 17% in group 2. No clinical bladder dysfunction during the follow-up (mean
follow-up 50 months).
CONCLUSIONS
Bladder hitch ureteral reimplantation is a safe and reliable technique as primary procedure in
children under 1-year.