Long-term outcome analysis of Starr plication for primary obstructive megaureters

The Journal of Urology
Peter C FretzC E Hawtrey

Abstract

The Starr technique of tapering megaureters was first reported in 1979. Although this method of ureteral plication is well known, to our knowledge there are no clinical studies regarding outcomes. We report the first long-term outcome results with the Starr technique for primary obstructive megaureters. Three girls and 10 boys with a total of 16 primary obstructive megaureters (3 bilateral) underwent reimplantation with Starr plication between 1988 and 2000. Baseline and followup renal function (average followup 6.2 years) was determined with renal scan and/or 24-hour urinary creatinine clearance. Average age at operation was 5.6 years (range 2 months to 13 years). All ureters were plicated using the Starr technique with interrupted polydioxanone sutures performed by a single surgeon (CEH). Reimplantation methods were the Hendren technique in 7 and Politano-Leadbetter in 9. No ureter demonstrated obstruction postoperatively. One ureter refluxed, which resolved with subureteral collagen injection. Seven patients had mean preoperative and postoperative creatinine clearance +/- SD 72.9 +/- 14.8 and 102.1 +/- 10.9 cc per minute, respectively (p <0.05). Six patients underwent preoperative and postoperative renal scans. Average preop...Continue Reading

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Citations

Feb 26, 2009·Current Urology Reports·David M Kitchens, C D Anthony Herndon
Aug 21, 2007·Journal of Endourology·Abdol-Mohammad KajbafzadehVahid Najjaran-Tousi
Aug 13, 2013·Journal of Pediatric Surgery·Kwang Hyun KimSang Won Han
Nov 24, 2012·The Journal of Urology·M M C van den HeijkantT P V M de Jong
Oct 25, 2008·Journal of Pediatric Urology·D Ben-MeirJ M Hutson
Sep 8, 2005·The Journal of Urology·Francisco OssandonMichele Torre
Aug 6, 2016·Arab Journal of Urology·Tamer M Abou YoussifMohammed Adel Atta
May 26, 2020·European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery ... [et Al] = Zeitschrift Für Kinderchirurgie·Binyamin B NeemanBoris Chertin

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