Using the renal pelvis flap to replace the whole hypoplastic ureter: a preliminary report

El-Asmar, Khaled M.; El-Shafei, Ehab A.; Abdel-Hay, Sameh

Annals of Pediatric Surgery:
doi: 10.1097/01.XPS.0000450334.54379.e5
Original Articles
Abstract

Background: Hypoplastic ureter is a rare condition usually associated with hypoplastic kidney, and it ends with nephrectomy in most of the cases. Many techniques have been described as ureteric substitutes in the literature. Here, we describe a new technique using the renal pelvis flap to replace the whole hypoplastic ureter in two cases.

Objective: The aim of this study was to describe a new surgical technique in the management of ureteric hypoplasia.

Patients and methods: Of the two boys diagnosed antenatally, unilateral hydronephrosis was detected in one boy and a huge renal cyst was present in the other, with evidence of postnatal progressive obstruction necessitating surgical intervention. On exploration, hypoplastic ureter throughout its entire length was an accidental intraoperative finding. The renal pelvis flap was taken and tubularized to replace the entire ureter, and reimplanted into the urinary bladder. This technique was the primary procedure in one case, whereas it was the secondary procedure in the other case after failure of initial trial of pyeloplasty.

Results: The postoperative period was uneventful with adequate drainage of the renal pelvis in the short-term follow-up (6 and 3 months consecutively).

Conclusion: The renal pelvis flap is a new feasible alternative procedure for ureteric replacement in a hypoplastic ureter when there is preserved renal parenchyma.

Author Information

Department of Pediatric Surgery, Ain Shams University, Cairo, Egypt

Correspondence to Khaled M. El-Asmar, MD, MRCS, FEBPS, 14 Mostafasadek El-Rafeay, Heliopolis, 11361, Cairo, Egypt Tel: +20 100 122 2624; fax: +02 24830833; e-mail: khaled.elasmar@med.asu.edu.eg

Received February 13, 2014

Accepted May 11, 2014

© 2014 Annals of Pediatric Surgery