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Ardavan Akhavan - One of the best experts on this subject based on the ideXlab platform.
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Upper Pole Heminephrectomy Versus Lower Pole Ureteroureterostomy for Ectopic Upper Pole Ureters
Current Urology Reports, 2017Co-Authors: Jason E. Michaud, Ardavan AkhavanAbstract:Purpose of Review Ureteral duplication and ectopic upper pole ureters are commonly associated with renal pathology, including vesicoureteral reflux, obstruction, infection, and renal function loss. There remains no consensus on the most appropriate management of these complex patients. In this review, we sought to compare existing data on upper pole heminephrectomy with ipsilateral Ureteroureterostomy. Recent Findings Application of magnetic resonance imaging and minimally invasive techniques have led to changes in the diagnosis and treatment of ectopic upper pole ureters. Recent studies have highlighted the safety of laparoscopic and robot-assisted upper pole heminephrectomy and Ureteroureterostomy. Summary Minimally invasive approaches to ectopic upper pole ureters appear safe and effective, with complication rates remaining low. Minimally invasive upper pole heminephrectomy carries a higher risk of lower pole function loss. Both upper pole heminephrectomy and Ureteroureterostomy carry a small risk of additional surgery on the bladder and remnant ureter.
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Upper Pole Heminephrectomy Versus Lower Pole Ureteroureterostomy for Ectopic Upper Pole Ureters.
Current Urology Reports, 2017Co-Authors: Jason Michaud, Ardavan AkhavanAbstract:Purpose of Review Ureteral duplication and ectopic upper pole ureters are commonly associated with renal pathology, including vesicoureteral reflux, obstruction, infection, and renal function loss. There remains no consensus on the most appropriate management of these complex patients. In this review, we sought to compare existing data on upper pole heminephrectomy with ipsilateral Ureteroureterostomy.
Peter D Furness - One of the best experts on this subject based on the ideXlab platform.
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ipsilateral Ureteroureterostomy in the surgical management of the severely dilated ureter in ureteral duplication
The Journal of Urology, 2008Co-Authors: Job K Chacko, Martin A. Koyle, Gerald C Mingin, Peter D FurnessAbstract:Purpose: Ipsilateral Ureteroureterostomy for the surgical management of severely dilated ureter in ureteral duplication is well supported in the surgical literature but often not done. We evaluated our institutional experience with Ureteroureterostomy in duplication anomalies to assess the feasibility and success of this procedure.Materials and Methods: An 8-year retrospective review of the records of all patients with complete renal duplex anomalies was evaluated. Anatomical presentations, and operative and nonoperative treatment of these patients were evaluated.Results: A total of 193 patients were identified with complete renal duplication. Associated anomalies included ureterocele in 24 patients, ectopic ureter in 38 and vesicoureteral reflux in 57. Of 193 patients 160 (83%) with duplex anomalies underwent surgical intervention with a total of 41 ureteroureterostomies performed in 39 patients with dilated donor ureters. A total of 11 ureteroureterostomies were performed primarily and 30 were performed...
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Ipsilateral Ureteroureterostomy in the surgical management of the severely dilated ureter in ureteral duplication.
The Journal of urology, 2007Co-Authors: Job K Chacko, Martin A. Koyle, Gerald C Mingin, Peter D FurnessAbstract:Ipsilateral Ureteroureterostomy for the surgical management of severely dilated ureter in ureteral duplication is well supported in the surgical literature but often not done. We evaluated our institutional experience with Ureteroureterostomy in duplication anomalies to assess the feasibility and success of this procedure. An 8-year retrospective review of the records of all patients with complete renal duplex anomalies was evaluated. Anatomical presentations, and operative and nonoperative treatment of these patients were evaluated. A total of 193 patients were identified with complete renal duplication. Associated anomalies included ureterocele in 24 patients, ectopic ureter in 38 and vesicoureteral reflux in 57. Of 193 patients 160 (83%) with duplex anomalies underwent surgical intervention with a total of 41 ureteroureterostomies performed in 39 patients with dilated donor ureters. A total of 11 ureteroureterostomies were performed primarily and 30 were performed in conjunction with ipsilateral ureteral reimplantation of the distal common segment below the Ureteroureterostomy. Ten of the 39 patients had the contralateral side reimplanted for vesicoureteral reflux. In all children with Ureteroureterostomy the anastomosis between the 2 ureters remained patent. Two of the 11 children who underwent Ureteroureterostomy alone had de novo ipsilateral vesicoureteral reflux (1), which was treated with ureteral reimplantation, and subureteral injection (1). Two children who underwent concomitant Ureteroureterostomy and reimplantation without indwelling stents had transient postoperative urinomas that required subsequent drainage. Additionally, 3 patients had persistent ipsilateral vesicoureteral reflux, which was treated with subureteral injection in 1 and observation in 2. One patient presented with transient ipsilateral urinary obstruction, which required percutaneous drainage and resolved spontaneously. In cases of ureteral duplication with a severely dilated ureter requiring surgical intervention ipsilateral Ureteroureterostomy is a viable option for reflux and/or obstruction. The procedure is rapid and technically feasible, and it offers excellent cosmesis. In addition, Ureteroureterostomy has minimal morbidity and it facilitates early hospital discharge.
Martin A. Koyle - One of the best experts on this subject based on the ideXlab platform.
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Ureteroureterostomy: An Alternative to Ureteroneocystostomy in Select Cases of Pediatric Renal Transplantation
The Journal of Urology, 2017Co-Authors: Frank J. Penna, Armando J. Lorenzo, Walid A. Farhat, Hissan Butt, Martin A. KoyleAbstract:Purpose: Ureteroneocystostomy is the standard mode of establishing urinary drainage in renal transplantation. However, donor-to-recipient Ureteroureterostomy may be considered in the presence of a challenging bladder or an augmented bladder, or when the donor ureter might be compromised or is too short. This approach also preserves a nonrefluxing system with an orthotopic ureteral orifice.Materials and Methods: We retrospectively reviewed the records of all pediatric renal transplantations in which Ureteroureterostomy was performed at a single tertiary care pediatric center over the 12-year period from 2004 to 2015. Ureteroureterostomy was performed in end-to-side fashion from donor-to-recipient ureter. Patients with a history of symptomatic vesicoureteral reflux were excluded from Ureteroureterostomy. Parameters were reviewed, including age, gender, source of renal transplantation (deceased or living donor), indications for Ureteroureterostomy and complications.Results: Primary Ureteroureterostomy was pe...
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Ureteroureterostomy: An Alternative to Ureteroneocystostomy in Select Cases of Pediatric Renal Transplantation.
The Journal of urology, 2016Co-Authors: Frank J. Penna, Armando J. Lorenzo, Walid A. Farhat, Hissan Butt, Martin A. KoyleAbstract:Ureteroneocystostomy is the standard mode of establishing urinary drainage in renal transplantation. However, donor-to-recipient Ureteroureterostomy may be considered in the presence of a challenging bladder or an augmented bladder, or when the donor ureter might be compromised or is too short. This approach also preserves a nonrefluxing system with an orthotopic ureteral orifice. We retrospectively reviewed the records of all pediatric renal transplantations in which Ureteroureterostomy was performed at a single tertiary care pediatric center over the 12-year period from 2004 to 2015. Ureteroureterostomy was performed in end-to-side fashion from donor-to-recipient ureter. Patients with a history of symptomatic vesicoureteral reflux were excluded from Ureteroureterostomy. Parameters were reviewed, including age, gender, source of renal transplantation (deceased or living donor), indications for Ureteroureterostomy and complications. Primary Ureteroureterostomy was performed at 23 of the 213 renal transplantations (10.8%). At transplantation mean ± SD age was 11.7 ± 4.9 years and mean weight was 33.5 ± 18.9 kg. Two secondary ureteroureterostomies were done to salvage the ureter due to complications after ureteroneocystostomy. Of the patients 60% and 40% underwent Ureteroureterostomy during deceased and living donor renal transplantation, respectively. The most common indications included a challenging small bladder due to anuria, a valve bladder and a neurogenic augmented bladder. Two urinary leaks (8%) occurred and no allografts were lost. Ureteroureterostomy is a safe alternative to standard ureteroneocystostomy in renal transplantation. Ureteroureterostomy should be considered a primary option in certain complex situations and secondarily as a salvage procedure when ureteral problems develop after ureteroneocystostomy in patients who undergo renal transplantation. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
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ipsilateral Ureteroureterostomy in the surgical management of the severely dilated ureter in ureteral duplication
The Journal of Urology, 2008Co-Authors: Job K Chacko, Martin A. Koyle, Gerald C Mingin, Peter D FurnessAbstract:Purpose: Ipsilateral Ureteroureterostomy for the surgical management of severely dilated ureter in ureteral duplication is well supported in the surgical literature but often not done. We evaluated our institutional experience with Ureteroureterostomy in duplication anomalies to assess the feasibility and success of this procedure.Materials and Methods: An 8-year retrospective review of the records of all patients with complete renal duplex anomalies was evaluated. Anatomical presentations, and operative and nonoperative treatment of these patients were evaluated.Results: A total of 193 patients were identified with complete renal duplication. Associated anomalies included ureterocele in 24 patients, ectopic ureter in 38 and vesicoureteral reflux in 57. Of 193 patients 160 (83%) with duplex anomalies underwent surgical intervention with a total of 41 ureteroureterostomies performed in 39 patients with dilated donor ureters. A total of 11 ureteroureterostomies were performed primarily and 30 were performed...
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Ipsilateral Ureteroureterostomy in the surgical management of the severely dilated ureter in ureteral duplication.
The Journal of urology, 2007Co-Authors: Job K Chacko, Martin A. Koyle, Gerald C Mingin, Peter D FurnessAbstract:Ipsilateral Ureteroureterostomy for the surgical management of severely dilated ureter in ureteral duplication is well supported in the surgical literature but often not done. We evaluated our institutional experience with Ureteroureterostomy in duplication anomalies to assess the feasibility and success of this procedure. An 8-year retrospective review of the records of all patients with complete renal duplex anomalies was evaluated. Anatomical presentations, and operative and nonoperative treatment of these patients were evaluated. A total of 193 patients were identified with complete renal duplication. Associated anomalies included ureterocele in 24 patients, ectopic ureter in 38 and vesicoureteral reflux in 57. Of 193 patients 160 (83%) with duplex anomalies underwent surgical intervention with a total of 41 ureteroureterostomies performed in 39 patients with dilated donor ureters. A total of 11 ureteroureterostomies were performed primarily and 30 were performed in conjunction with ipsilateral ureteral reimplantation of the distal common segment below the Ureteroureterostomy. Ten of the 39 patients had the contralateral side reimplanted for vesicoureteral reflux. In all children with Ureteroureterostomy the anastomosis between the 2 ureters remained patent. Two of the 11 children who underwent Ureteroureterostomy alone had de novo ipsilateral vesicoureteral reflux (1), which was treated with ureteral reimplantation, and subureteral injection (1). Two children who underwent concomitant Ureteroureterostomy and reimplantation without indwelling stents had transient postoperative urinomas that required subsequent drainage. Additionally, 3 patients had persistent ipsilateral vesicoureteral reflux, which was treated with subureteral injection in 1 and observation in 2. One patient presented with transient ipsilateral urinary obstruction, which required percutaneous drainage and resolved spontaneously. In cases of ureteral duplication with a severely dilated ureter requiring surgical intervention ipsilateral Ureteroureterostomy is a viable option for reflux and/or obstruction. The procedure is rapid and technically feasible, and it offers excellent cosmesis. In addition, Ureteroureterostomy has minimal morbidity and it facilitates early hospital discharge.
Job K Chacko - One of the best experts on this subject based on the ideXlab platform.
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ipsilateral Ureteroureterostomy in the surgical management of the severely dilated ureter in ureteral duplication
The Journal of Urology, 2008Co-Authors: Job K Chacko, Martin A. Koyle, Gerald C Mingin, Peter D FurnessAbstract:Purpose: Ipsilateral Ureteroureterostomy for the surgical management of severely dilated ureter in ureteral duplication is well supported in the surgical literature but often not done. We evaluated our institutional experience with Ureteroureterostomy in duplication anomalies to assess the feasibility and success of this procedure.Materials and Methods: An 8-year retrospective review of the records of all patients with complete renal duplex anomalies was evaluated. Anatomical presentations, and operative and nonoperative treatment of these patients were evaluated.Results: A total of 193 patients were identified with complete renal duplication. Associated anomalies included ureterocele in 24 patients, ectopic ureter in 38 and vesicoureteral reflux in 57. Of 193 patients 160 (83%) with duplex anomalies underwent surgical intervention with a total of 41 ureteroureterostomies performed in 39 patients with dilated donor ureters. A total of 11 ureteroureterostomies were performed primarily and 30 were performed...
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Ipsilateral Ureteroureterostomy in the surgical management of the severely dilated ureter in ureteral duplication.
The Journal of urology, 2007Co-Authors: Job K Chacko, Martin A. Koyle, Gerald C Mingin, Peter D FurnessAbstract:Ipsilateral Ureteroureterostomy for the surgical management of severely dilated ureter in ureteral duplication is well supported in the surgical literature but often not done. We evaluated our institutional experience with Ureteroureterostomy in duplication anomalies to assess the feasibility and success of this procedure. An 8-year retrospective review of the records of all patients with complete renal duplex anomalies was evaluated. Anatomical presentations, and operative and nonoperative treatment of these patients were evaluated. A total of 193 patients were identified with complete renal duplication. Associated anomalies included ureterocele in 24 patients, ectopic ureter in 38 and vesicoureteral reflux in 57. Of 193 patients 160 (83%) with duplex anomalies underwent surgical intervention with a total of 41 ureteroureterostomies performed in 39 patients with dilated donor ureters. A total of 11 ureteroureterostomies were performed primarily and 30 were performed in conjunction with ipsilateral ureteral reimplantation of the distal common segment below the Ureteroureterostomy. Ten of the 39 patients had the contralateral side reimplanted for vesicoureteral reflux. In all children with Ureteroureterostomy the anastomosis between the 2 ureters remained patent. Two of the 11 children who underwent Ureteroureterostomy alone had de novo ipsilateral vesicoureteral reflux (1), which was treated with ureteral reimplantation, and subureteral injection (1). Two children who underwent concomitant Ureteroureterostomy and reimplantation without indwelling stents had transient postoperative urinomas that required subsequent drainage. Additionally, 3 patients had persistent ipsilateral vesicoureteral reflux, which was treated with subureteral injection in 1 and observation in 2. One patient presented with transient ipsilateral urinary obstruction, which required percutaneous drainage and resolved spontaneously. In cases of ureteral duplication with a severely dilated ureter requiring surgical intervention ipsilateral Ureteroureterostomy is a viable option for reflux and/or obstruction. The procedure is rapid and technically feasible, and it offers excellent cosmesis. In addition, Ureteroureterostomy has minimal morbidity and it facilitates early hospital discharge.
Gerald C Mingin - One of the best experts on this subject based on the ideXlab platform.
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ipsilateral Ureteroureterostomy in the surgical management of the severely dilated ureter in ureteral duplication
The Journal of Urology, 2008Co-Authors: Job K Chacko, Martin A. Koyle, Gerald C Mingin, Peter D FurnessAbstract:Purpose: Ipsilateral Ureteroureterostomy for the surgical management of severely dilated ureter in ureteral duplication is well supported in the surgical literature but often not done. We evaluated our institutional experience with Ureteroureterostomy in duplication anomalies to assess the feasibility and success of this procedure.Materials and Methods: An 8-year retrospective review of the records of all patients with complete renal duplex anomalies was evaluated. Anatomical presentations, and operative and nonoperative treatment of these patients were evaluated.Results: A total of 193 patients were identified with complete renal duplication. Associated anomalies included ureterocele in 24 patients, ectopic ureter in 38 and vesicoureteral reflux in 57. Of 193 patients 160 (83%) with duplex anomalies underwent surgical intervention with a total of 41 ureteroureterostomies performed in 39 patients with dilated donor ureters. A total of 11 ureteroureterostomies were performed primarily and 30 were performed...
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Ipsilateral Ureteroureterostomy in the surgical management of the severely dilated ureter in ureteral duplication.
The Journal of urology, 2007Co-Authors: Job K Chacko, Martin A. Koyle, Gerald C Mingin, Peter D FurnessAbstract:Ipsilateral Ureteroureterostomy for the surgical management of severely dilated ureter in ureteral duplication is well supported in the surgical literature but often not done. We evaluated our institutional experience with Ureteroureterostomy in duplication anomalies to assess the feasibility and success of this procedure. An 8-year retrospective review of the records of all patients with complete renal duplex anomalies was evaluated. Anatomical presentations, and operative and nonoperative treatment of these patients were evaluated. A total of 193 patients were identified with complete renal duplication. Associated anomalies included ureterocele in 24 patients, ectopic ureter in 38 and vesicoureteral reflux in 57. Of 193 patients 160 (83%) with duplex anomalies underwent surgical intervention with a total of 41 ureteroureterostomies performed in 39 patients with dilated donor ureters. A total of 11 ureteroureterostomies were performed primarily and 30 were performed in conjunction with ipsilateral ureteral reimplantation of the distal common segment below the Ureteroureterostomy. Ten of the 39 patients had the contralateral side reimplanted for vesicoureteral reflux. In all children with Ureteroureterostomy the anastomosis between the 2 ureters remained patent. Two of the 11 children who underwent Ureteroureterostomy alone had de novo ipsilateral vesicoureteral reflux (1), which was treated with ureteral reimplantation, and subureteral injection (1). Two children who underwent concomitant Ureteroureterostomy and reimplantation without indwelling stents had transient postoperative urinomas that required subsequent drainage. Additionally, 3 patients had persistent ipsilateral vesicoureteral reflux, which was treated with subureteral injection in 1 and observation in 2. One patient presented with transient ipsilateral urinary obstruction, which required percutaneous drainage and resolved spontaneously. In cases of ureteral duplication with a severely dilated ureter requiring surgical intervention ipsilateral Ureteroureterostomy is a viable option for reflux and/or obstruction. The procedure is rapid and technically feasible, and it offers excellent cosmesis. In addition, Ureteroureterostomy has minimal morbidity and it facilitates early hospital discharge.
