ESPU Congress 2017 - Abstract book

298

CONGRESS OF THE ESPU

VS-26 (VS without presentation)

PEDIATRIC TREATMENT OF A COMPLETE DUPLEX

SYSTEM WITH REFLUX AND ECTOPIC URETEROCELE

ASSOCIATED WITH ROBOT-ASSISTED LAPAROSCOPY

URETEROPYELOSTOMY

Erika LLORENS DE KNECHT, Anna BUJONS, Andres KANASHIRO,

Jorge CAFFARATTI and Humberto VILLAVICENCIO

Fundació Puigvert, Pediatric Urology, Barcelona, SPAIN

INTRODUCTION

The incidence of a complete duplex system occurs in 0.75%, it's more common in female.

Exceptionally it's presented with reflux in the lower pole and obstruction in the upper pole due to an

ectopic ureterocele. Its identification and treatment is complex. If both poles have good function,

a conservative reconstructive proceedure can be performed, with a proximal anastomosis or a distal

reimplantation of the obstructed system.

MATERIAL AND METHODS

A 4-year-old girl with bilateral complete duplex system presents at the right side: low grade reflux at

the low pole and obstruction at the upper system due to an ectopic ureterocele. Because of the good

renal function (>30%) a proximal ureteropyelostomy with distal ureter resection was performed.

RESULTS

In a first surgical time a Deflux

injection was done; in a second one a catheterization of the

lower system in a lithotomy position was performed. Afterwards, in a left lateral decubitus position,

a laparoscopic robot-assisted ureteropyelostomy and a distal ureteric resection was performed. Our

surgical time was 180 minutes with less than 50ml intraoperative bleeding. The hospital discharge

was after 3 days and the catheter removal after 1 month. Actually the patient is asymptomatic and

with normal renal function.

CONCLUSIONS

Ureteric duplicity is uncommon, moreover if its accompanied of reflux of the upper pole due to an

ectopic ureterocele. If function is conserved, a laparoscopic robot-assisted ureteropyelostomy is

a valid option and feasible in specialized centres with good functional outcomes.

VS-27 (VS without presentation)

LAPAROSCOPIC PERITONEAL VAGINOPLASTY USING

DAVYDOV PRINCIPLE

Haluk EMIR

Istanbul University, Cerrahpasa Medical Faculty, Deptartment of Pediatric Surgery, Division of Pediatric Urology, Istanbul,

TURKEY

PURPOSE

Options for vaginal replacement are intestinal segments, skin grafts or dilatation of the vaginal

stump. Davydov reported the use of the uterorectal peritonium for vaginoplasty in 1969 and in the

following years the method has also been applied laparoscopically.