Laparoscopic ureteropyeloanastomosis in the treatment of duplex system

• Main Authors: Marcelo Hisano, Francisco T. Denes, Artur H. Brito, Marcos Lucon, Marcos G. Machado, Homero Bruschini, Miguel Srougi
• Format: Article
• Language: English
• Published: Sociedade Brasileira de Urologia 2012-04-01
• Series: International Brazilian Journal of Urology
• Subjects: laparoscopy; kidney; congenital abnormalities
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382012000200012

PURPOSE: Duplex system is one of the most common anomalies of upper urinary tract. Anatomical and clinical presentation determine its treatment. Usually, the upper moiety has a poor function and requires resection, but when it is not significantly impaired, preservation is recommended. Laparoscopic reconstruction with upper pole preservation is presented as an alternative treatment. MATERIALS AND METHODS: Four female patients with duplex system, one presenting with recurrent urinary tract infection and the others with urinary incontinence associated to infrasphincteric ectopic ureter, were treated. Surgical procedure envolved a laparoscopic ureteropyeloanastomosis of the upper pole ureter to the pelvis of the lower moiety, with prior insertion of a double J stent. RESULTS: Surgical time varied from 120 to 150 minutes, with minimal blood loss in all cases. Follow-up varied from 15 to 30 months, with resolution of the clinical symptoms and preservation of the upper moiety function. CONCLUSION: Laparoscopic ureteropyeloanatomosis is a feasible and safe minimally invasive option in the treatment of duplex system.