Extravesical detrusorrhaphy for refluxing ureters associated with paraureteral diverticula.

OBJECTIVES

To demonstrate the effectiveness of an extravesical approach to refluxing ureters associated with paraureteral diverticula.

METHODS

Over a 39-month period, 23 children underwent repair of Hutch diverticula with refluxing ureters using an extravesical approach. Seventeen had unilateral reflux with an ipsilateral diverticulum, 4 had bilateral reflux with a unilateral diverticulum, and 2 had bilateral reflux with bilateral diverticula. Overall, 25 ureters with associated diverticula were repaired.

RESULTS

Twenty ureters were repaired with a nondismembered technique and 5 with a dismembered technique. Twenty-two of the 23 patients (96%) were successfully repaired with this approach. Three patients had transient reflux postoperatively, which resolved spontaneously within 6 months. One patient who underwent bilateral dismembered procedures for bilateral diverticula has persistent unilateral grade II reflux postoperatively. No patient developed ureteral obstruction.

CONCLUSIONS

The major advantage of this technique is seen in the minimal postoperative morbidity. The extravesical approach is a safe, simple, and effective method for the management of a refluxing ureter with an associated diverticulum.