Hosseini Sharifi S H, Nabavizadeh B, Mozafarpour S, Kajbafzadeh A-M
Pediatric Urology Research Center, Pediatric Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran.
Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
J Pediatr Urol. 2017 Apr;13(2):217-218. doi: 10.1016/j.jpurol.2016.12.006. Epub 2017 Jan 13.
The aim of this study was to present a novel laparoscopic technique for persistent urinary incontinence in pediatrics due to ectopic ureter associated with poor functioning upper renal moiety.
This technique consisted of laparoscopic clipping of the upper moiety artery and vein. The ectopic ureter was also clipped afterwards without upper pole partial nephrectomy.
The patient was a seven-year-old girl with persistent urinary incontinence and confirmation of duplex kidney with poor functioning upper moiety in pre-operative investigations. The upper moiety ureter was ectopically drained to the vaginal cavity. She was immediately dry after surgery and discharged on the second postoperative day. During the follow-up period of 14 months, she was continent and symptom-free. Hydronephrosis was not visualized in follow-up ultrasonography.
This laparoscopic upper renal moiety vascular and ureteral clipping without partial nephrectomy could serve as a promising, safe and simple alternative in the treatment of patients with ectopic ureter associated with poor functioning renal moiety. Also, ipsilateral normal functioning moiety would not be associated with potential morbidity in this technique.
本研究的目的是提出一种新颖的腹腔镜技术，用于治疗小儿因异位输尿管合并上肾段功能不良所致的持续性尿失禁。
该技术包括腹腔镜夹闭上肾段动静脉。随后在不进行上极部分肾切除术的情况下夹闭异位输尿管。
该患者为一名7岁女孩，存在持续性尿失禁，术前检查确诊为重复肾且上肾段功能不良。上肾段输尿管异位开口于阴道腔。术后她立即不再漏尿，并于术后第二天出院。在14个月的随访期内，她尿控良好且无症状。随访超声检查未发现肾积水。
这种不进行部分肾切除术的腹腔镜上肾段血管和输尿管夹闭术，可作为治疗合并肾段功能不良的异位输尿管患者的一种有前景、安全且简单的替代方法。此外，该技术不会给同侧功能正常的肾段带来潜在的发病风险。
