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.
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.
Authors: Jiledar Rawat; Kumar Abdul Rashid; Ravi P Kanojia; Shiv N Kureel; Raj K Tandon Journal: Int Urol Nephrol Date: 2008-08-15 Impact factor: 2.370