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19–22 APRIL, 2017, BARCELONA, SPAIN
14:57–15:02
S17-5 (VP)
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LAPAROSCOPIC EXTRAVESICAL TRANSVERSE
URETERAL REIMPLANTATION IN OBSTRUCTIVE
MEGAURETER
Sergey BONDARENKO
1
and Ilia KAGANTSOV
2
1) Regional Hospital 7, Pediatric Urology, Volgograd, RUSSIAN FEDERATION - 2) Children’s Republican Hospital,
Pediatric Urology, Syktyvkar, RUSSIAN FEDERATION
PURPOSE
We report our experience with laparoscopic dismembered extravesical transverse ureteral reim-
plantation in children with unilateral primary ureterovesical junction obstruction.
MATERIAL AND METHODS
The age of the patient is 3 months. The right side grade IY ureterohydronephrosis was diagnosed
prenatally. At the age of two months the boy had acute pyelonephritis. No evidence of vesicoureteral
reflux was defined by voiding cystogram but intravenous urography shows grade IY hydronephrosis
with extremely dilated ureter. Laparoscopic dismembered extravesical transverse ureteral reimplan-
tation with extracorporeal tapering of the ureter and psoas-hitch was performed.
RESULTS
There were not major intraoperative complications. The operative time was 150 minutes. In 6 months
and year follow-up period intravenous urogram demonstrated improvement of the dilatation of
the pelvicaliceal system and ureter. No vesicoureteral reflux was detected by voiding cystogram.
Seventeen children (16 patients were male and 1 female, aged 3 months to 5 years) underwent
laparoscopic dismembered extravesical transverse ureteral reimplantation. In all patients surgery
was completed laparoscopicaly without conversion to open procedure; there were not major in-
traoperative complications. The mean operative time was 180 minutes (range 150-210 min). In
6 months and year follow-up period intravenous urogram and intravenous urogram demonstrated
improvement of the dilatation of the pelvicaliceal systems and ureters in all patients; in two cases
vesicoureteral reflux developed and was successfully treated by endoscopic urodex injection.
CONCLUSIONS
We could consider this technique as an eventual option when dismembered extravesical reimplan-
tation is needed. The procedure is ergonomically easier than conventional Lich-Gregoir technique.
15:02–15:17
Discussion