Summary
Congenital mid ureteric valve (MUV) stenosis is a very rare cause of ureteric obstruction
and hydronephrosis (HN) in children. We describe how we manage laparoscopically one
case of a patient with congenital MUV.
We describe a 6-month-old boy born with antenatal left HN, with an anteroposterior
diameter (APD) of 1,5 cm. Follow-up renal ultrasound at 3 months of age showed an
increase in left kidney HN, approximately 2.5 cm below the PUJ associated with distal
stenosis. Renal scintigraphy with DTPA showed an obstructive pattern. Urography scan
showed an abrupt reduction in the caliber of the mid left ureter Based on a preoperative
diagnosis of MUV stenosis, we performed a laparoscopic left ureteroplasty.
Abrupt tapering of the left ureter at 3 cm from the PUJ was identified. Proximal ureter
repair was performed before the resection of the narrowing segment. The two edges
of the ureter were spatulated and continuous anastomosis was performed without tension.
An antegrade JJ stent was inserted after the posterior part of the anastomosis was
done. Patient made an uneventful recovery and was discharged on the first postoperative
day.
Laparoscopic ureteroplasty is a complex but feasible option to treat patients with
congenital MUV stenosis.
Keywords
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References
- Congenital mid ureteric valve stenosis revisited: case report and review of the literature.Front Pediatr. 2019; 7https://doi.org/10.3389/fped.2019.00108
- Ureteral valves in children.Urology. 1998; 51: 7-11https://doi.org/10.1016/S0090-4295(98)00063-6
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- Congenital midureteral stricture in children diagnosed with antenatal hydronephrosis.Urology. 2004; 64: 1014-1019https://doi.org/10.1016/j.urology.2004.06.015
Article info
Publication history
Published online: October 22, 2020
Accepted:
October 18,
2020
Received in revised form:
September 17,
2020
Received:
July 8,
2020
Identification
Copyright
© 2020 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
