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Ipsilateral ureteroureterostomy: does function of the obstructed moiety matter?
Upper pole nephrectomy has been the traditional surgical management of children with poorly functioning upper pole moieties in duplex renal collecting systems having ureteral ectopia and ureterocele. However, ablative surgery confers a risk of functional loss to the remnant moiety due to vasospasm o...
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| Published in: | Journal of pediatric urology 2019-02, Vol.15 (1), p.50.e1-50.e6 |
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| container_title | Journal of pediatric urology |
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| creator | Kawal, T. Srinivasan, A.K. Talwar, R. Chu, D.I. Long, C. Weiss, D. Van Batavia, J. Kolon, T.F. Shukla, A.R. |
| description | Upper pole nephrectomy has been the traditional surgical management of children with poorly functioning upper pole moieties in duplex renal collecting systems having ureteral ectopia and ureterocele. However, ablative surgery confers a risk of functional loss to the remnant moiety due to vasospasm or vascular injury. It was hypothesized that ipsilateral ureteroureterostomy (IUU) is a safe and feasible approach for the management of these patients and that residual function in the obstructed upper pole does not affect surgical outcomes.
All patients with duplex systems who underwent IUU between 2010 and 2016 were retrospectively reviewed. Patients were sorted into two groups based on pre-operative imaging: those having |
| doi_str_mv | 10.1016/j.jpurol.2018.08.012 |
| format | article |
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All patients with duplex systems who underwent IUU between 2010 and 2016 were retrospectively reviewed. Patients were sorted into two groups based on pre-operative imaging: those having <10% upper pole moiety function (UPMF) and those having ≥ 10% UPMF. Outcomes assessed were postoperative complications (Clavien–Dindo classification), need for secondary surgery, and radiological outcomes.
The study cohort comprised 53 children with ectopia or ureterocele affecting the upper pole in a duplex system, 21 with UPMF <10% (median function 0% and median age 1.49 years) and 32 with UPMF ≥ 10% (median function 15% and median age 0.91 years). Median follow-up was 27.4 months and 27.6 months. In both the groups, prenatal hydronephrosis was the most common presentation (57% and 56%, respectively; p = 0.18) followed by urinary tract infection. Mann–Whitney U test comparing the two groups revealed no significant differences in any of the outcomes assessed. No patient required secondary surgery.
Ipsilateral ureteroureterostomy is a safe, definitive surgical intervention that preserves the renal architecture in children with duplex collecting systems regardless of upper pole function. [Display omitted]</description><identifier>ISSN: 1477-5131</identifier><identifier>EISSN: 1873-4898</identifier><identifier>DOI: 10.1016/j.jpurol.2018.08.012</identifier><identifier>PMID: 30243559</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Child, Preschool ; Duplex kindey ; Ectopic ureter drop ; Female ; Humans ; Infant ; Male ; Obstructed moiety function ; Postoperative Complications - epidemiology ; Retrospective Studies ; Ureter - abnormalities ; Ureter - surgery ; Ureteral Obstruction - etiology ; Ureteral Obstruction - physiopathology ; Ureteral Obstruction - surgery ; Ureterocele - complications ; Ureterocele - surgery ; Ureterostomy - methods ; Ureteroureterostomy</subject><ispartof>Journal of pediatric urology, 2019-02, Vol.15 (1), p.50.e1-50.e6</ispartof><rights>2018</rights><rights>Copyright © 2018. Published by Elsevier Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c362t-19c43e16e252f8e25db3331e06871ad3b89835bc677420a79d1fac3e7b7148ae3</citedby><cites>FETCH-LOGICAL-c362t-19c43e16e252f8e25db3331e06871ad3b89835bc677420a79d1fac3e7b7148ae3</cites><orcidid>0000-0002-1348-6201 ; 0000-0002-7972-4671</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30243559$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kawal, T.</creatorcontrib><creatorcontrib>Srinivasan, A.K.</creatorcontrib><creatorcontrib>Talwar, R.</creatorcontrib><creatorcontrib>Chu, D.I.</creatorcontrib><creatorcontrib>Long, C.</creatorcontrib><creatorcontrib>Weiss, D.</creatorcontrib><creatorcontrib>Van Batavia, J.</creatorcontrib><creatorcontrib>Kolon, T.F.</creatorcontrib><creatorcontrib>Shukla, A.R.</creatorcontrib><title>Ipsilateral ureteroureterostomy: does function of the obstructed moiety matter?</title><title>Journal of pediatric urology</title><addtitle>J Pediatr Urol</addtitle><description>Upper pole nephrectomy has been the traditional surgical management of children with poorly functioning upper pole moieties in duplex renal collecting systems having ureteral ectopia and ureterocele. However, ablative surgery confers a risk of functional loss to the remnant moiety due to vasospasm or vascular injury. It was hypothesized that ipsilateral ureteroureterostomy (IUU) is a safe and feasible approach for the management of these patients and that residual function in the obstructed upper pole does not affect surgical outcomes.
All patients with duplex systems who underwent IUU between 2010 and 2016 were retrospectively reviewed. Patients were sorted into two groups based on pre-operative imaging: those having <10% upper pole moiety function (UPMF) and those having ≥ 10% UPMF. Outcomes assessed were postoperative complications (Clavien–Dindo classification), need for secondary surgery, and radiological outcomes.
The study cohort comprised 53 children with ectopia or ureterocele affecting the upper pole in a duplex system, 21 with UPMF <10% (median function 0% and median age 1.49 years) and 32 with UPMF ≥ 10% (median function 15% and median age 0.91 years). Median follow-up was 27.4 months and 27.6 months. In both the groups, prenatal hydronephrosis was the most common presentation (57% and 56%, respectively; p = 0.18) followed by urinary tract infection. Mann–Whitney U test comparing the two groups revealed no significant differences in any of the outcomes assessed. No patient required secondary surgery.
Ipsilateral ureteroureterostomy is a safe, definitive surgical intervention that preserves the renal architecture in children with duplex collecting systems regardless of upper pole function. [Display omitted]</description><subject>Child, Preschool</subject><subject>Duplex kindey</subject><subject>Ectopic ureter drop</subject><subject>Female</subject><subject>Humans</subject><subject>Infant</subject><subject>Male</subject><subject>Obstructed moiety function</subject><subject>Postoperative Complications - epidemiology</subject><subject>Retrospective Studies</subject><subject>Ureter - abnormalities</subject><subject>Ureter - surgery</subject><subject>Ureteral Obstruction - etiology</subject><subject>Ureteral Obstruction - physiopathology</subject><subject>Ureteral Obstruction - surgery</subject><subject>Ureterocele - complications</subject><subject>Ureterocele - surgery</subject><subject>Ureterostomy - methods</subject><subject>Ureteroureterostomy</subject><issn>1477-5131</issn><issn>1873-4898</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp9UE1LAzEUDKJYrf4DkT162ZqXZDe7HhQpfhQKveg5ZLNvMWW3qUlW6L830upRGN68w8x7zBByBXQGFMrb9Wy9Hb3rZ4xCNaMJwI7IGVSS56Kqq-O0CynzAjhMyHkIa0q5pKw-JRNOmeBFUZ-R1WIbbK8jet1no8e0uAOF6IbdXdY6DFk3bky0bpO5LosfmLkmRD-aiG02OItxlw06JtPDBTnpdB_w8sBT8v789DZ_zZerl8X8cZkbXrKYQ20ERyiRFayr0mwbzjkgLSsJuuVNCsCLxpRSCka1rFvotOEoGwmi0sin5GZ_d-vd54ghqsEGg32vN-jGoBgASFGVtUhSsZealCl47NTW20H7nQKqfqpUa7WvUv1UqWgCsGS7PnwYmwHbP9Nvd0lwvxdgyvll0atgLG4Mttajiap19v8P3zR8iAg</recordid><startdate>201902</startdate><enddate>201902</enddate><creator>Kawal, T.</creator><creator>Srinivasan, A.K.</creator><creator>Talwar, R.</creator><creator>Chu, D.I.</creator><creator>Long, C.</creator><creator>Weiss, D.</creator><creator>Van Batavia, J.</creator><creator>Kolon, T.F.</creator><creator>Shukla, A.R.</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1348-6201</orcidid><orcidid>https://orcid.org/0000-0002-7972-4671</orcidid></search><sort><creationdate>201902</creationdate><title>Ipsilateral ureteroureterostomy: does function of the obstructed moiety matter?</title><author>Kawal, T. ; Srinivasan, A.K. ; Talwar, R. ; Chu, D.I. ; Long, C. ; Weiss, D. ; Van Batavia, J. ; Kolon, T.F. ; Shukla, A.R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c362t-19c43e16e252f8e25db3331e06871ad3b89835bc677420a79d1fac3e7b7148ae3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Child, Preschool</topic><topic>Duplex kindey</topic><topic>Ectopic ureter drop</topic><topic>Female</topic><topic>Humans</topic><topic>Infant</topic><topic>Male</topic><topic>Obstructed moiety function</topic><topic>Postoperative Complications - epidemiology</topic><topic>Retrospective Studies</topic><topic>Ureter - abnormalities</topic><topic>Ureter - surgery</topic><topic>Ureteral Obstruction - etiology</topic><topic>Ureteral Obstruction - physiopathology</topic><topic>Ureteral Obstruction - surgery</topic><topic>Ureterocele - complications</topic><topic>Ureterocele - surgery</topic><topic>Ureterostomy - methods</topic><topic>Ureteroureterostomy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kawal, T.</creatorcontrib><creatorcontrib>Srinivasan, A.K.</creatorcontrib><creatorcontrib>Talwar, R.</creatorcontrib><creatorcontrib>Chu, D.I.</creatorcontrib><creatorcontrib>Long, C.</creatorcontrib><creatorcontrib>Weiss, D.</creatorcontrib><creatorcontrib>Van Batavia, J.</creatorcontrib><creatorcontrib>Kolon, T.F.</creatorcontrib><creatorcontrib>Shukla, A.R.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of pediatric urology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kawal, T.</au><au>Srinivasan, A.K.</au><au>Talwar, R.</au><au>Chu, D.I.</au><au>Long, C.</au><au>Weiss, D.</au><au>Van Batavia, J.</au><au>Kolon, T.F.</au><au>Shukla, A.R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ipsilateral ureteroureterostomy: does function of the obstructed moiety matter?</atitle><jtitle>Journal of pediatric urology</jtitle><addtitle>J Pediatr Urol</addtitle><date>2019-02</date><risdate>2019</risdate><volume>15</volume><issue>1</issue><spage>50.e1</spage><epage>50.e6</epage><pages>50.e1-50.e6</pages><issn>1477-5131</issn><eissn>1873-4898</eissn><abstract>Upper pole nephrectomy has been the traditional surgical management of children with poorly functioning upper pole moieties in duplex renal collecting systems having ureteral ectopia and ureterocele. However, ablative surgery confers a risk of functional loss to the remnant moiety due to vasospasm or vascular injury. It was hypothesized that ipsilateral ureteroureterostomy (IUU) is a safe and feasible approach for the management of these patients and that residual function in the obstructed upper pole does not affect surgical outcomes.
All patients with duplex systems who underwent IUU between 2010 and 2016 were retrospectively reviewed. Patients were sorted into two groups based on pre-operative imaging: those having <10% upper pole moiety function (UPMF) and those having ≥ 10% UPMF. Outcomes assessed were postoperative complications (Clavien–Dindo classification), need for secondary surgery, and radiological outcomes.
The study cohort comprised 53 children with ectopia or ureterocele affecting the upper pole in a duplex system, 21 with UPMF <10% (median function 0% and median age 1.49 years) and 32 with UPMF ≥ 10% (median function 15% and median age 0.91 years). Median follow-up was 27.4 months and 27.6 months. In both the groups, prenatal hydronephrosis was the most common presentation (57% and 56%, respectively; p = 0.18) followed by urinary tract infection. Mann–Whitney U test comparing the two groups revealed no significant differences in any of the outcomes assessed. No patient required secondary surgery.
Ipsilateral ureteroureterostomy is a safe, definitive surgical intervention that preserves the renal architecture in children with duplex collecting systems regardless of upper pole function. [Display omitted]</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>30243559</pmid><doi>10.1016/j.jpurol.2018.08.012</doi><orcidid>https://orcid.org/0000-0002-1348-6201</orcidid><orcidid>https://orcid.org/0000-0002-7972-4671</orcidid></addata></record> |
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| issn | 1477-5131 1873-4898 |
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| source | Elsevier |
| subjects | Child, Preschool Duplex kindey Ectopic ureter drop Female Humans Infant Male Obstructed moiety function Postoperative Complications - epidemiology Retrospective Studies Ureter - abnormalities Ureter - surgery Ureteral Obstruction - etiology Ureteral Obstruction - physiopathology Ureteral Obstruction - surgery Ureterocele - complications Ureterocele - surgery Ureterostomy - methods Ureteroureterostomy |
| title | Ipsilateral ureteroureterostomy: does function of the obstructed moiety matter? |
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