Upper pole heminephrectomy: is complete ureterectomy necessary?
BJU Int
; 88(1): 77-9, 2001 Jul.
Article
en En
| MEDLINE
| ID: mdl-11446851
ABSTRACT
OBJECTIVE:
To determine the re-operation rate on the distal ureter after upper pole heminephrectomy with incomplete ureterectomy. PATIENTS ANDMETHODS:
The case notes from one institution were reviewed retrospectively; 60 upper pole heminephrectomies with incomplete ureterectomy were undertaken in 39 girls and 16 boys (mean age at primary surgery 27 months, range 3--88).RESULTS:
Thirty-two children (58%) had an antenatal diagnosis while 12 (22%) presented with a urinary tract infection (UTI) and six (11%) with urinary incontinence. Twenty-nine of the 60 renal units (48%) had an associated ureterocele and in nine (15%) the ureter was ectopic. Ten infants (18%) underwent initial puncture of a ureterocele. Five patients (8%), all females, required lower urinary tract re-operation. The indications for secondary surgery were recurrent UTIs in all and a prolapsed ureterocele in one. All five had ultrasonographic evidence of a dilated ureteric stump. Reflux into the retained stump was detected in one child.CONCLUSIONS:
The re-operation rate for a redundant ureteric stump in this series was 8%. The risk of injury to the good ureter may outweigh the benefits of a complete ureterectomy.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Uréter
/
Enfermedades Ureterales
/
Nefrectomía
Tipo de estudio:
Observational_studies
/
Prognostic_studies
Límite:
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
Idioma:
En
Revista:
BJU Int
Asunto de la revista:
UROLOGIA
Año:
2001
Tipo del documento:
Article
País de afiliación:
Reino Unido