Utilizing an Umbilical Ligament for Complex Ureteroneocystostomy

Urology
Futoshi MatsuiTakuya Ito

Abstract

To overcome the tension of anastomosis between ureter and bladder for complex ureteroneocystostomy in children, we describe a novel technique utilizing an ipsilateral umbilical ligament (occluded umbilical artery) to fix the bladder. From July 1991 to December 2013, 18 patients (13 girls, 5 boys) underwent our technique for complex ureteroneocystostomy. Median age at surgery was 61 months. The main indications for surgery were ectopic ureter in 9 patients, primary obstructive megaureter in 3, and persistent vesicoureteral reflux after surgery in 2. The ipsilateral umbilical ligament was ligated. A new hiatus was created craniolateral to the original hiatus. The submucosal tunnel was created trans-trigonally. The umbilical ligament was sutured to the whole bladder muscle at the hiatus. Ureteroneocystostomy was then performed. Mean duration of postoperative follow-up was 62.6 months. Seventeen patients underwent unilateral ureteroneocystostomy with our technique. One patient underwent bilateral ureteroneocystostomy with our technique on one side. Vesicoureteral reflux was not shown in 92.3% of patients and no signs of obstruction developed in any patients. No complications were encountered with our procedure. Utilizing an umbilic...Continue Reading

References

Dec 1, 1969·British Journal of Urology·R T Warwick, P H Worth
Apr 1, 1996·Urology·J J KowalczykR M Ehrlich
Nov 20, 1997·The Journal of Urology·R Mathews, F F Marshall
Oct 25, 2008·Journal of Pediatric Urology·T J CrookP S J Malone
Jun 14, 2013·BJU International·Raimund SteinJoachim W Thüroff

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