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19–22 APRIL, 2017, BARCELONA, SPAIN
VS-2 (VS without presentation)
LAPAROSCOPIC URETEROURETEROSTOMY
FOR RETROCAVAL URETER – CASE PRESENTATION
Y. RUDIN, D. MARUKHNENKO and G. LAGUTIN
N. Lopatkin Scientific Research Institute of Urology and Interventional Radiology, Paediatric Urology Department,
Moscow, RUSSIAN FEDERATION
AIM & PATIENT
To share our experience of laparoscopic ureteroureterostomy (UU) that we successfully applied for
surgical therapy of retrocaval ureter.
Patient 14 yo male. Previously asymptomatic. Presented with 3-month history of right flank dull
intermittent pains. Physical examination . Laboratory evaluations. US - the right upper urinary tract
dilatation ( Upper ureter - 18-22мм, Pelvis up to 29-35мм, Caleces 15-20мм.
CT S-shaped appearance of the Right upper ureter due to the location of the ureter posterior to the
inferior vena cava (IVC). Right kidney function satisfactory.
PROCEDURE
Laparoscopic Right Ureteroureterostomy.Left side lumbotomy position. Infraumbilical approach,
5mm optic and working ports x2 in triangular arrangement. JJ stent 6Ch 26 mm. Operative time
- 57 min.
The point of the ureteric obstruction behind the IVC was located. Just above this point the distended
ureter was transsected. The both ends then were relocated in the antevasal position.
The care was taken to prevent devascularisation of the diveded ends. The distal narrowed part
was spatulated at the lenght approximaetly 4.0-5.0 cm. The anastomosis was carried out using
continuous suture 6/0 monocryl.
RESULTS
Prompt uneventful recovery. Discharged on the day 5. Stent removed in 1 month.
Follow up at the intervals 3, 6 and 9 months. Asymptomatic. US - remarkable improvement in the
pelvio-caleceal appearance.
CONCLUSIONS
Laparosopic approach is very convenient to run ureteroureterostomy for retrokaval ureter.
VS-3 (VS without presentation)
URETEROVESICOSTOMY: A FRESH APPROACH
TO PRIMARY MEGAURETER
J.M. MING, F.A. ALYAMI, A.J. LORENZO and M.A. KOYLE
Hospital for Sick Children, Urology, Toronto, CANADA
PURPOSE
The approach to a massively dilated ureter in an infant can be quite complex. Multiple surgical
options exist, including cutaneous ureterostomies and ureteral re-implantation. Here we would like
to introduce a new approach of a non-dismembered refluxing anastomosis for the repair of primary
megaureters.
PATIENT AND METHODS
A2 month old male with bilateral primary megaureters presented to clinic with a history of one febrile
urinary tract infection and worsening grade IV hydroureteronephrosis. Renogram revealed 50%
split function with delayed drainage of the ureters. After appropriate counseling, his family elected to
undergo bilateral ureterovesicostomies in the operating room.