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A modified technique for ureteral reimplantation: Intravesical detrusorrhaphy

Authors
 Kwang Hyun Kim  ;  Yong Seung Lee  ;  Young Jae Im  ;  Cho Nyeong Lee  ;  Sang Won Han 
Citation
 JOURNAL OF PEDIATRIC SURGERY, Vol.48(8) : 1813-1818, 2013 
Journal Title
 JOURNAL OF PEDIATRIC SURGERY 
ISSN
 0022-3468 
Issue Date
2013
MeSH
Anastomosis, Surgical ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Hydronephrosis/diagnostic imaging ; Hydronephrosis/surgery ; Infant ; Male ; Mucous Membrane/surgery ; Postoperative Complications/prevention & control ; Replantation/methods* ; Retrospective Studies ; Treatment Outcome ; Ureter/abnormalities ; Ureter/diagnostic imaging ; Ureter/surgery* ; Ureteral Obstruction/etiology ; Ureteral Obstruction/surgery ; Urinary Bladder/diagnostic imaging ; Urinary Bladder/surgery* ; Urography ; Vesico-Ureteral Reflux/surgery
Keywords
Replantation ; Ureter ; Urinary bladder ; Vesico-ureteral reflux
Abstract
PURPOSE: To describe the surgical procedure of intravesical detrusorrhaphy, a modified technique of ureteral reimplantation, and report our initial experience. METHODS: From October 2007 to March 2012, 55 children with vesicoureteral reflux (VUR) and 13 children with obstructive megaureter (OM) underwent intravesical detrusorrhaphy. All surgical procedures were performed via an open intravesical approach. The ureter was mobilized, and the bladder mucosa was separated from the detrusor in a cephalad direction. The separated detrusor was incised vertically and repaired underneath the mobilized ureter to create the submucosal tunnel. The ureteral orifice was anastomosed to its orthotopic position. RESULTS: Of 31 patients treated with bilateral intravesical detrusorrhaphy, no patient had postoperative urinary retention. Follow-up voiding cystourethrography was performed in 45 patients with 72 reimplanted ureters. VUR was resolved in 41 patients (91.1%) with 68 ureters (94.4%). Among 13 patients with 14 ureters treated for OM, hydroureteronephorosis improved in 11 patients (84.6%) with 12 ureters (85.7%). CONCLUSIONS: Intravesical detrusorrhaphy is modified technique of ureteral reimplantation, which recreates the neo-ureteric orifice in the orthotopic position and does not produce postoperative urinary retention in bilateral cases. Intravesical detrusorrhaphy is safe and effective in treating patients with VUR or OM.
Full Text
http://www.sciencedirect.com/science/article/pii/S0022346813004296
DOI
10.1016/j.jpedsurg.2013.05.017
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kwang Hyun(김광현)
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
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/88223
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