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Laparoscopic Intravesical Detrusorrhaphy With Ureteral Plication for Megaureter: A Novel Technique

 Sang Woon Kim  ;  Neddy Lee Lim  ;  Yong Seung Lee  ;  Sang Won Han  ;  Young Jae Im 
 UROLOGY, Vol.86(1) : 187-191, 2015 
Journal Title
Issue Date
Adolescent ; Adult ; Child ; Child, Preschool ; Cystoscopy/methods* ; Female ; Follow-Up Studies ; Humans ; Infant ; Laparoscopy/methods* ; Male ; Operative Time ; Reconstructive Surgical Procedures/methods* ; Retrospective Studies ; Treatment Outcome ; Ureter/abnormalities* ; Ureter/surgery ; Ureteral Diseases/congenital ; Ureteral Diseases/surgery* ; Urologic Surgical Procedures/methods* ; Young Adult
INTRODUCTION: To demonstrate the novel technique of laparoscopic intravesical detrusorrhaphy with ureteral plication for megaureter.

TECHNICAL CONSIDERATIONS: From December 2012 to June 2014, 11 patients with primary unilateral megaureter underwent laparoscopic intravesical detrusorrhaphy with ureteral plication. By a transvesicoscopic approach using a 3-port technique, the ureter was mobilized and plicated with a 6F Foley catheter. After dissection of the bladder mucosa in a semilunar shape, the detrusor was incised vertically and repaired underneath the mobilized ureter to create a submucosal tunnel. The ureter was covered with bladder mucosa, and the ureteral orifice was anastomosed to its orthotopic neoureteric orifice. The mean age of the included patients at the time of surgery was 9.18 years (range, 12 months-24 years). All surgeries were successfully completed without open conversion, with a mean operation time of 214 minutes including preoperative evaluation. All patients tolerated the procedure without any complications. Within the mean follow-up duration of 12.6 months (range, 5-24 months), no complications related to the surgery were reported, and no vesicoureteral reflux was detected in the operated side on postoperative voiding cystourethrography. The distal ureteral diameter was significantly reduced (from 21.1 to 11.6 mm), and the grade of hydronephrosis was decreased on postoperative ultrasonography without deterioration of renal function.

CONCLUSION: In this study, laparoscopic intravesical detrusorrhaphy with ureteral plication demonstrated successful short-term outcomes in management of megaureter in children and adults. Our technique can be an effective and feasible surgical option in the treatment of megaureter.
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sang Woon(김상운) ORCID logo https://orcid.org/0000-0002-5790-1948
Lee, Yong Seung(이용승) ORCID logo https://orcid.org/0000-0003-3778-9888
Im, Young Jae(임영재)
Han, Sang Won(한상원) ORCID logo https://orcid.org/0000-0003-0941-1300
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