Cases reported "Vesico-Ureteral Reflux"

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1/9. Surgical treatment of reflux in completely duplicated ureters.

    Vesicoureteral reflux occurs in approximately 50% of duplex systems that undergo evaluation and most commonly involves the lower renal segment ureter. The therapeutic approach can be tailored for each case after careful evaluation of the anatomic and functional status of each renal unit. If reparative srugery is indicated and only one ureter is involved, then ureteropyelostomy or ureteroureterostomy have yielded excellent results. If more than one ureter is involved with either relfux or obstruction, then reimplantation of the paired ureters is indicated if the renal units are slavageable.
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ranking = 1
keywords = ureterostomy
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2/9. Ureteral triplication (type I) with vesicoureteral reflux.

    Complete triplication of ureter associated with vesicoureteral reflux successfully treated with ureteroureterostomy is described. The principle of the Weigert-Meyer law applies to complete triplication of the ureter.
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ranking = 1
keywords = ureterostomy
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3/9. Undiversion with ileocecal segment following high transureteroureterostomy.

    A boy presenting with a small bladder and refluxing blind-ending ureteral stumps following multiple attempts at ureteral reimplantation and supravesical diversion with a high left-to-right transureteroureterostomy and right cutaneous ureterostomy underwent successful undiversion. Surgery consisted of bilateral ureterectomy and ileocecocystoplasty, with intussusception of the ileocecal valve and anastomosis of the ileal tail to the right renal pelvis.
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ranking = 6
keywords = ureterostomy
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4/9. Vesicoureteral reflux in complete ureteral duplication: surgical options.

    Vesicoureteral reflux is the most common abnormality seen with complete ureteral duplication. The majority of cases require surgical correction. The techniques used in 62 patients with 71 duplicated systems with reflux are reviewed. Reflux into the lower pole was encountered in 51 duplicated systems, both poles in 19 systems and the upper pole in 1. A total of 42 conjoint ureteral reimplantations was performed but in 8 cases only the lower pole ureter with reflux was reimplanted after it was separated from the nonrefluxing ureter. Ipsilateral ureteroureterostomy was performed in 19 cases of lower pole reflux. Two patients underwent lower pole heminephrectomy. Satisfactory results were obtained by all 3 reconstructive techniques. However, for lower pole reflux we recommend ipsilateral ureteroureterostomy unless a contralateral operation also is necessary. Ureteroureterostomy proved to be a simple and safe operation free of complications, with little morbidity and requiring a shorter hospitalization.
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ranking = 3
keywords = ureterostomy
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5/9. The fate of loop ureterostomy and severe contracted bladder.

    Bladder contracture following cutaneous loop ureterostomy is a known but sometimes neglected serious complication. Recently we treated a boy successfully by effecting an increase in bladder capacity by long-term hydraulic dilatation prior to performing colonic augmentation. The severity of the contracture seems to be the worst ever published in the literature.
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ranking = 5
keywords = ureterostomy
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6/9. Ipsilateral ureteroureterostomy for single ureteral disease in patients with ureteral duplication: a review of 8 years of experience with 16 patients.

    Ipsilateral ureteroureterostomy near the bladder (end-to-side anastomosis) for treatment of single ureteral disease in patients with complete ureteral duplication has been performed in 16 patients during the last 8 years. The operative technique, indications, results, followup and complications are presented. Reflux in the lower segment ureter was treated in 13 patients and upper segment ectopia or ureterocele was managed in 3 patients with this operative procedure. This operative technique is simpler and safer than reimplantation of both ureters into the bladder. Because no dissection of the bladder wall is needed there is less risk of injury to the pelvic viscera and vasculature. The chance of success in correcting reflux appears better than with reimplantation of both ureters into the bladder. Long-term followup has shown few complications and no repeat operations were needed in this series. The small stump of the diseased ureter left behind near the bladder caused no serious problems.
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ranking = 5
keywords = ureterostomy
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7/9. Recent advances and further experience with surgical techniques for one-stage total remodeling of massively dilated ureters.

    One-stage total ureteral remodeling was done in a selected group of 64 megaureters in 44 children. Two new surgical techniques have been developed and utilized during the past six years. They were designed to preserve the ureteral blood supply and accomplish reconstruction of the whole ureter in one operation. The tapering in situ technique was utilized in 39 ureters and ureteral plication either alone or in conjunction with lower-third ureteral tapering in 25 ureters. These methods proved to be invaluable in the following selected cases: (1) massive ureteral dilatation and tortuosity due to vesicoureteral reflux or obstruction, (2) secondary operations following previous urinary diversion or unsatisfactory ureteral tailoring, (3) multiple obstructions within the same ureter, (4) transureteroureterostomy of dilated ureters, and (5) definitive surgery for dilated ipsilateral ureter of complete duplication.
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ranking = 1
keywords = ureterostomy
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8/9. The spectrum of ureteropelvic junction obstructions occurring in duplicated collecting systems.

    The authors reviewed four cases of ureteropelvic junction obstruction (UPJ) in duplicated systems. Associated abnormalities included contralateral duplication, vesicoureteral reflux, and a case of ipsilateral upper pole ectopic ureter with a dysplastic upper pole moiety. Surgical management included dismembered pyeloplasty, ureteral reimplantation, end-to-side pyeloureterostomy to the upper-pole ureter, and upper-pole heminephrectomy with lower-pole dismembered pyeloplasty. UPJ obstructions occurring in duplicated systems often are associated with other anomalies.
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ranking = 1
keywords = ureterostomy
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9/9. Ipsilateral ureteroureterostomy for vesicoureteral reflux in duplicated ureters.

    In most duplex systems reflux only occurs to the lower segment and these patients present with symptoms of recurrent pyelonephritis. We have treated 12 such cases by ipsilateral ureteroureterostomy with good results. Treatment of this condition in most major pediatric urologic centers consists of reimplanting the duplicated ureters but we recommend an ipsilateral ureteroureterostomy because of lower morbidity, relative lack of complications, ease of operation and excellent long-term results.
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ranking = 6
keywords = ureterostomy
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