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Case Reports
. 2021 Nov 19;5(2):132-135.
doi: 10.1002/iju5.12401. eCollection 2022 Mar.

A novel method of transvesicoscopic ureteral reimplantation of an ectopic ureter with a mate ureter in a duplex kidney

Hidenori Nishio  1 , Kentaro Mizuno  1 , Daisuke Matsumoto  2 , Taiki Kato  2 , Hideyuki Kamisawa  2 , Satoshi Kurokawa  2 , Akihiro Nakane  3 , Tetsuji Maruyama  2 , Takahiro Yasui  2 , Yutaro Hayashi  1
Affiliations
Case Reports

A novel method of transvesicoscopic ureteral reimplantation of an ectopic ureter with a mate ureter in a duplex kidney

Hidenori Nishio et al. IJU Case Rep. .

Abstract

Introduction: The reimplantation of an ectopic ureter is still performed as an open surgery, although laparoscopic or robot-assisted laparoscopic surgery has gained popularity as a minimally invasive treatment for pediatric urological disorders.

Case presentation: A 15-day-old Japanese boy was referred to our hospital with right hydronephrosis. A detailed examination revealed complete ureteral duplication on the right side and a dilated ectopic upper pole ureter, opening into the prostatic urethra. Since the patient had recurrent febrile urinary tract infections, we performed plication and ureteral reimplantation of the dilated ectopic ureter using a transvesicoscopic surgical method at the age of 2 years and 5 months.

Conclusion: We safely performed transvesicoscopic ureteral reimplantation for an ectopic upper pole ureter with a mate ureter in a duplex kidney, following the detection of an ectopic ureter within the bladder, due to the prior understanding of the wrapping of both ureters in a common sheath.

Keywords: common sheath; duplex kidney; ectopic ureter; transvesicoscopic ureteral reimplantation; ureteroplasty.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
T2‐weighted magnetic resonance image shows a right ectopic upper pole ureter in a duplex kidney. The ectopic ureter is dilated throughout its length. The arrowhead indicates a dilated ectopic ureter. (a) Transverse plane, (b) coronal plane.
Fig. 2
Fig. 2
DMSA scan shows the following DEFs: 20.4%, right upper pole; 32.7%, right lower pole; 46.9%, left kidney.
Fig. 3
Fig. 3
Urethral cystoscopy and retrograde pyelography findings. (a) Urethral cystoscopy findings indicate the location of the ectopic ureteral orifice of the right upper pole. The ectopic ureter opens beside the verumontanum at the prostatic urethra. The arrow indicates the ectopic ureteral orifice. V, verumontanum. (b) Retrograde pyelography shows that the right ectopic upper pole ureter is contrasted. The arrowhead indicates the dilated ectopic ureter.
Fig. 4
Fig. 4
Schema of the transvesicoscopic UR for an ectopic ureter with a mate ureter in a duplex kidney. (a) A 5‐F catheter is inserted into the right lower pole ureter and fixed by 5‐0 absorbable sutures. (b) The right lower pole ureter is dissected. L, lower pole ureter. (c) The dilated ectopic upper pole ureter is detected through the hiatus by searching immediately posterior to the lower pole ureter. E, ectopic upper pole ureter. (d) The ectopic upper pole ureter is dissected. (e) The ectopic upper pole ureter is cut off. (f) The muscular defect in the ureteral hiatus is repaired using 4‐0 absorbable sutures. (g) The dilated ectopic upper pole ureter is plicated using 5‐0 absorbable sutures. (h) After the creation of the submucosal tunnel, both ectopic upper pole ureter and lower pole ureter are drawn gently together through the tunnel. A 4‐F catheter is inserted into the right upper pole ureter.
See this image and copyright information in PMC

References

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