Advertisement

Laparoscopic ureteral reconstruction in infant with congenital mid ureteric valve

Published:October 22, 2020DOI:https://doi.org/10.1016/j.jpurol.2020.10.022

      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

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Pediatric Urology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Elifranji M.
        • Elkadahi A.
        • Charles A.
        • Abbas T.O.
        Congenital mid ureteric valve stenosis revisited: case report and review of the literature.
        Front Pediatr. 2019; 7https://doi.org/10.3389/fped.2019.00108
        • Rabinowitz R.
        • Kingston T.E.
        • Wesselhoeft C.
        • Caldamone A.A.
        Ureteral valves in children.
        Urology. 1998; 51: 7-11https://doi.org/10.1016/S0090-4295(98)00063-6
        • Gupta R.
        • Borwankar S.
        • Parelkar S.
        Ureteric valve: case report with an insight into anatomy, embryology, presentation and management.
        Indian J Urol. 2008; 24: 561-563https://doi.org/10.4103/0970-1591.44269
        • Smith B.G.
        • Metwalli A.R.
        • Leach J.
        • Cheng E.Y.
        • Kropp B.P.
        Congenital midureteral stricture in children diagnosed with antenatal hydronephrosis.
        Urology. 2004; 64: 1014-1019https://doi.org/10.1016/j.urology.2004.06.015