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Journal of Pediatric Surgery
Article . 2013 . Peer-reviewed
License: Elsevier TDM
Data sources: Crossref
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A modified technique for ureteral reimplantation: Intravesical detrusorrhaphy

Authors: Cho Nyeong Lee; Sang Won Han; Kwang Hyun Kim; Yong Seung Lee; Young Jae Im;

A modified technique for ureteral reimplantation: Intravesical detrusorrhaphy

Abstract

To describe the surgical procedure of intravesical detrusorrhaphy, a modified technique of ureteral reimplantation, and report our initial experience.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.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%).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.

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Keywords

Male, Hydronephrosis/surgery, Anastomosis, Postoperative Complications/prevention & control, Vesico-Ureteral Reflux/surgery, Urinary Bladder, 610, Hydronephrosis, Replantation/methods*, Ureter/abnormalities, Ureteral Obstruction/etiology, Postoperative Complications, Surgical, 617, Humans, Child, Preschool, Urinary Bladder/surgery*, Mucous Membrane/surgery, Retrospective Studies, Vesico-Ureteral Reflux, Ureteral Obstruction/surgery, Mucous Membrane, Ureter/surgery*, Anastomosis, Surgical, Ureter/diagnostic imaging, Vesico-ureteral reflux, Infant, Hydronephrosis/diagnostic imaging, Urography, Urinary bladder, Treatment Outcome, Child, Preschool, Replantation, Female, Ureter, Urinary Bladder/diagnostic imaging, Follow-Up Studies, Ureteral Obstruction

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
9
Average
Top 10%
Average
Green