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Indian J Urol 2021 Jan-Mar;37(1):79-81. Epub 2021 Jan 1.

Department of Urology, Lourdes Hospital, Kochi, Kerala, India.

Urethral duplication (UD) in a female is a rare congenital anomaly. Although UD is commonly associated with other congenital anomalies of the urinary tract, its association with congenital megacystis with obstructive megaureter has not yet been reported. We present the case of a 9 year old girl child with complete sagittal duplication of the urethra associated with congenital megacystis and left obstructive megaureter. Read More

Int Braz J Urol 2021 Jul-Aug;47(4):821-826

Unidade de Urologia Pediátrica, Divisão de Urologia, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo - FMUSP, SP, Brasil.

Introduction: Symptomatic duplex kidneys usually present with recurrent urinary tract infection due to ureteral obstruction (megaureter, ureterocele or ectopic ureter) and/or vesicoureteral reflux. Upper-pole nephrectomy is a widely accepted procedure to correct symptomatic duplex systems with poor functioning moieties, also known as upper or proximal approach. The distal ureteral stump syndrome (DUSS) can be a late complication of this approach. Read More

Cir Pediatr 2021 Apr 1;34(2):100-104. Epub 2021 Apr 1.

Interventional Radiology Department. La Paz University Hospital. Madrid (Spain).

Objectives: Congenital primary obstructive megaureter (POM) is caused by ureterovesical junction stenosis, reduced peristalsis, and the resulting dilatation. Even though ureteral re-implantation remains the current gold standard technique, retrograde dilatation is considered as an effective therapeutic alternative with good results and growing proponents - to the extent it has become the technique of choice in some healthcare facilities. The objective was to present an alternative approach for treatment purposes. Read More

Urologiia 2021 Mar(1):95-102

N.A. Lopatkin Research Institute of Urology and Interventional Radiology branch of the National Medical Research Radiological Center, Moscow, Russia.

Background: pneumovesicoscopic approach gives new possibilities for endovideosurgical correction of congenital ureteral and bladder pathology.

Aim: To increase the efficiency of ureteral reimplantation in patients with vesicoureteral reflux (VUR), obstructive megaureter and bladder pathology by using pneumovesicoscopic access.

Materials And Methods: For the period 2014 - 2020 a total of 52 children aged from 10 months up to 15 years (median 2. Read More

J Pediatr Urol 2021 Feb 16. Epub 2021 Feb 16.

Ondokuz Mayıs University, School of Medicine, Department of Pediatric Surgery, Ondokuz Mayıs Üniversitesi Kurupelit Kampüsü, Atakum, Samsun, 55270, Turkey. Electronic address:

Introduction: Ureteroneocsytostomy is a well-established procedure for correction of certain ureterovesical conditions like vesicoureteral reflux and ureterevesical obstruction. Amazing developments in technology paved the way for minimally invasive surgery and conventional procedures are increasingly being performed minimal invasively during the recent decades. Although Politano-Leadbetter ureteroneocystostomy is an anatomical repair, lost its popularity against Cohen's technique as it is more challenging to perform and requires extravesical dissection which may increase the complication rates. Read More

Pan Afr Med J 2020 2;37:296. Epub 2020 Dec 2.

Department of Urology A, Faculty of Medicine and Pharmacy, Ibn Sina University Hospital, Mohammed V University, Rabat, Morocco.

Radiographics 2021 Mar-Apr;41(2):462-486. Epub 2021 Jan 29.

From the Department of Radiology, Diagnósticos da América SA (DASA), Av Juruá 434, Alphaville Industrial, Barueri, SP 06455-010, Brazil.

The upper urinary tract is the most common human system affected by congenital anomalies. Congenital anomalies of the kidneys and ureters comprise a wide spectrum of disorders ranging from simple variants with no clinical significance to complex anomalies that may lead to severe complications and end-stage renal disease. They may be classified as anomalies of renal form, which are subclassified as structural anomalies (eg, persistent fetal lobulation, hypertrophied column of Bertin, and dromedary hump) and fusion anomalies (eg, horseshoe kidney and pancake kidney); anomalies of renal position (eg, renal malrotation, simple renal ectopia, and crossed renal ectopia) and renal number (eg, renal agenesis and supernumerary kidney); and abnormalities in development of the urinary collecting system (eg, pyelocaliceal diverticulum, megacalycosis, ureteropelvic junction obstruction, duplex collecting system, megaureter, ectopic ureter, and ureterocele). Read More

J Endourol Case Rep 2020 29;6(4):358-361. Epub 2020 Dec 29.

Department of Urology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.

Primary obstructed megaureter (POM) usually refers to primary dilated ureters in which vesicoureteral reflux and other secondary causes of lower ureteral obstruction have been ruled out. We herein present a case of obstructed megaureter with a dilated saccular lower end representing an ureterocele and concomitant multiple multifaceted stones almost completely filling the dilated tortuous ureter of a normally functioning and excreting kidney. Our index case was a 45-year-old lady with intermittent right flank pain for a year with acute colic since a week. Read More

J Gastrointest Surg 2021 Jun 8;25(6):1633-1634. Epub 2021 Jan 8.

Department of General Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK.

Klin Padiatr 2020 Dec 17. Epub 2020 Dec 17.

Pediatric Nephrology, University Children's Hospital Tübingen, Tuebingen, Germany.

Background: Knowledge of the baseline risk of febrile urinary tract infections in patients with primary non-refluxing megaureter can help clinicians to make informed decisions for offering continuous antibiotic prophylaxis.

Objective: The primary objective of this systematic review was to determine the pooled prevalence of febrile urinary tract infections in patients with primary non-refluxing megaureter selected for primary non-surgical management independent of associated attributed risk factors at initial presentation in order to assess the value of continuous antibiotic prophylaxis.

Methods: MEDLINE, EMBASE, and Cochrane Controlled Trials Register electronic databases were searched for eligible studies without language and time restriction. Read More

Urology 2021 Mar 28;149:216-221. Epub 2020 Oct 28.

Division of Urology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA; Division of Urology, Hospital of the University of Pennsylvania, Perelman Center for Advanced Care, 3400 Civic Center Blvd, 3(rd) Floor West Pavilion, Philadelphia, PA.

Objective: To describe the technical aspects of robot assisted laparoscopic ureteral reimplantation (RALUR) for the management of primary obstructive megaureter (POM) and report initial outcomes, safety, and feasibility of the procedure.

Methods: Using an IRB- approved robotic surgery registry, we performed a retrospective chart review of patients undergoing RALUR for POM between April 2009 and May 2019.

Results: A total of 18 patients underwent RALUR using a modified Lich-Gregoir technique for management of POM and 7 (38. Read More

Urology 2021 Mar 26;149:211-215. Epub 2020 Oct 26.

Department of Urology, Shamir Medical Center, Zerifin, Israel.

Objective: To compare 2 minimally invasive surgical options for the treatment of obstructed megaureter: robot assisted dismembered extravesical cross-trigonal ureteral reimplantation (RADECUR) and laparoscopic dismembered extravesical cross-trigonal ureteral reimplantation (LDECUR).

Methods: A 2 arm retrospective comparative study, including all pediatric patients who underwent ureteral reimplantation of unilateral obstructed megaureter, either by RADECUR or LDECUR. Patient demographics, perioperative surgical data, complications, and results are described. Read More

Pediatr Med Chir 2020 Oct 8;42(1). Epub 2020 Oct 8.

Paediatric Surgery and Paediatric Urology Department, Buzzi Children's Hospital, Milan.

Primary Obstructive Megaureter (POM) is a common cause of hydronephrosis in children with spontaneous resolution in most cases. High-Pressure Balloon Dilatation (HPBD) has been proposed as a minimally invasive procedure for POM correction in selected patients. The aim of the paper is to review our experience with HPBD in patients with POM. Read More

Int J Womens Health 2020 25;12:675-679. Epub 2020 Aug 25.

Department of Obstetrics and Gynecology, Fundación Valle del Lili, Cali, Colombia.

Trisomy 20p is a chromosomal anomaly resulting from whole or partial duplication of the short arm of chromosome 20. It is a rarely reported syndrome and it is estimated that there are only a few cases of this condition worldwide, which hampers the phenotypic characterization of this entity. Conversely, müllerian anomalies include a group of congenital malformations of the uterus, vagina, cervix, and fallopian tubes resulting from alterations in the embryological development of the müllerian ducts. Read More

J Endourol Case Rep 2019 30;5(3):88-91. Epub 2019 Aug 30.

Pediatric Urology, Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia.

Congenital mid-ureteral stricture (CMUS) is a rare diagnosis almost exclusively repaired with ureteroureterostomy in infancy or early childhood. We describe a unique case of a 2-year-old child with both a CMUS and ipsilateral obstructed megaureter, which was addressed in a single operative setting using a robotic Heineke-Mikulicz nondismembered ureteroplasty for the CMUS and a dismembered tapered extravesical ureteral reimplant for the obstructed megaureter. Compared with ureteroureterostomy, a nondismembered ureteroplasty for CMUS minimizes the risk of ureteral vascular compromise and can be particularly beneficial in cases where the affected ureter requires additional reconstruction. Read More

Case Rep Urol 2020 24;2020:8946435. Epub 2020 Jul 24.

Center for Anatomical Science and Education, Department of Surgery, Saint Louis University School of Medicine, Saint Louis, MO 63104, USA.

. A number of rare anatomical anomalies, including retroexternal iliac ureter, extrarenal calyces (ERCs), and vascular anomalies, were observed in a 96-year-old female cadaver during a routine dissection. . Read More

Front Pediatr 2020 2;8:353. Epub 2020 Jul 2.

McMaster Pediatric Surgical Research Collaborative, McMaster University, Hamilton, ON, Canada.

Previous scoring systems have used renal scan parameters to assess severity of ureteropelvic junction obstruction-like hydronephrosis (UPJO-like HN), however this information is not always reliable due to protocol variation across centers and renogram limitations. Therefore, we sought to evaluate the Pyeloplasty Prediction Score (PPS), which utilizes only baseline ultrasound measurements to predict the likelihood of pyeloplasty in infants with UPJO-like. PPS was developed using three ultrasound parameters, Society of Fetal Urology (SFU) grade, transverse anteroposterior (APD), and the absolute percentage difference of ipsilateral and contralateral renal lengths at baseline. Read More

Pediatr Nephrol 2021 Apr 21;36(4):865-868. Epub 2020 Jul 21.

Department of Pediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, ul. 3 Maja 13/15, 41-800, Zabrze, Poland.

Pediatr Nephrol 2021 Apr 21;36(4):863-864. Epub 2020 Jul 21.

Department of Pediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, ul. 3 Maja 13/15, 41-800, Zabrze, Poland.

Cureus 2020 Apr 7;12(4):e7577. Epub 2020 Apr 7.

Surgery/Pediatric Urology, University of Nebraska Medical Center, Omaha, USA.

Duplicated collecting systems have a predictable draining pattern that is described by the Meyer-Weigert rule. When there are abnormalities associated with duplicating collecting systems, the upper pole moiety drains inferomedially (most commonly associated with obstruction), and the lower pole moiety drains superolaterally (most commonly associated with vesicoureteral reflux). We present a case of an infant with a duplicated collecting system that violates the Meyer-Weigert rule with lower pole megaureter with massive dilation, ectopic insertion, and associated involuted lower pole renal moiety. Read More

J Laparoendosc Adv Surg Tech A 2020 Mar 26. Epub 2020 Mar 26.

Department of Pediatric Surgery & Urology, University Hospital of Vall d'Hebron, Barcelona, Spain.

Conservative management of primary obstructive megaureter (POM) appears as the best option in patients with adequate ureteral drainage. Nevertheless, surgical intervention is indicated in cases of recurrent urinary tract Infections (UTIs), deterioration of split renal function, and significant obstruction. The gold standard includes: Ureteral reimplantation with or without tapering by open approach. Read More

Front Pediatr 2020 6;8:62. Epub 2020 Mar 6.

Department of Pediatric Surgery, Qilu Hospital, Shandong University, Jinan, China.

To report our initial experience with a modified ureteral orthotopic reimplantation technique under pneumovesicum and compare the outcomes vs. those obtained with the Cohen technique under pneumovesicum for the correction of primary obstructive megaureter (POM) or vesicoureteral reflux(VUR) in pediatric patients. A total of 46 patients (38 POM and 8 VUR; mean age: 16. Read More

Urologe A 2020 Mar;59(3):261-265

Zentrum für Kinder‑, Jugend- und rekonstruktive Urologie, Universitätsmedizin Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland.

A primary, congenital megaureter means a dilatation of the ureter with a ureteric diameter ≥7 mm due to a structural or functional obstruction of the ureterovesical junction and represents the second most likely cause of neonatal hydronephrosis. Conservative management is the primary treatment option for many patients due to a high spontaneous remission rate of up to 85%. Concerning diagnostic management, meticulous and repeat postnatal evaluation by ultrasound is mandatory to identify patients who are at risk of renal deterioration. Read More

J Laparoendosc Adv Surg Tech A 2020 Mar 29;30(3):328-333. Epub 2020 Jan 29.

Department of Pediatric Surgery, Qilu Hospital of Shandong University, Jinan, China.

In this article, we report our experience on laparoscopic pneumovesical Cohen approach for vesicoureteral junction (VUJ) stricture in children and compared it with traditional open Cohen approach. Ninety-eight children (114 ureters) with VUJ stricture were involved in this study who were treated from January 2008 to December 2017. Forty-eight patients (56 ureters) treated with open Cohen approach from January 2008 to December 2011 were marked as Group 1 and 50 patients (58 ureters) treated with laparoscopic pneumovesical Cohen approach from January 2012 to December 2017 were marked as Group 2. Read More

Aktuelle Urol 2020 Apr 22;51(2):132-136. Epub 2020 Jan 22.

HELIOS Klinikum Duisburg, Abteilung für Kindernephro- und Kinderurologie (KiNU) an der St. Johannes Klinik, Duisburg.

The term "megaureter" is used to describe a markedly dilated ureter, irrespective of its underlying anatomic abnormality. Primary megaureters categorised as type I and II according to the Pfister-Hendren classification resolve spontaneously during the first years of life, whereas severely dilated type III megaureters have no potential to resolve on conservative management. Regarding this small group of very severely dilated type III megaureters, we recommend a two-step surgical approach: in a first step, we place a temporary splint-free ureterocutaneostomy for early disobstruction. Read More

Pediatr Int 2020 Jan 19;62(1):110-111. Epub 2020 Jan 19.

Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.

BJU Int 2020 04 26;125(4):602-609. Epub 2020 Jan 26.

Department of Paediatric Urology, Children's Medical Centre Tochigi, Jichi Medical University, Shimotuke, Japan.

Objective: To determine the long-term safety and efficacy of ureteric reimplantation with psoas bladder hitch (PBH) in patients aged <12 months with unilateral obstructive megaureter (OM).

Patients And Methods: We retrospectively compared a group of patients aged <12 months (study group) with an group of patients aged ≥12 months (comparison group), who underwent PBH for OM between September 2007 and April 2017, in terms of preoperative patient characteristics, intra- and peri-operative results, and postoperative results.

Results: The study group comprised seven infants, five boys and two girls. Read More

Pediatr Med Chir 2019 Dec 23;41(2). Epub 2019 Dec 23.

Department of Pediatric Surgery and Pediatric Minimally Invasive Surgery and New Technologies, San Bortolo Hospital, Vicenza.

The management of congenital primary obstructive megaureter (POM) is usually conservative, especially during the first year of life. Endoscopic high-pressure balloon dilatation (EHPBD) is indicated when symptoms, increasing dilatation and progressive renal damage are recorded, particularly in children younger than one year of age. We identified and described endoscopic prognostic factors predicting the success or failure of endoscopic dilatation. Read More

Prenat Diagn 2020 03 28;40(4):424-431. Epub 2020 Jan 28.

Department of Medical and Surgical Sciences, Institute of Obstetrics and Gynecology, University of Foggia, Foggia, Italy.

Objectives: To perform a systematic review of studies reporting the outcome of fetuses with a prenatal diagnosis of isolated duplex collecting system (DCS).

Methods: Inclusion criteria were studies reporting the outcome of fetuses with a prenatal diagnosis of isolated DCS, defined as DCS not associated with other major structural anomalies at the time of diagnosis. The outcomes observed were: imaging features of DCS on prenatal ultrasound, associated anomalies detected exclusively at prenatal follow-up ultrasound and at birth, abnormal karyotype, symptoms at birth (including vesicoureteral reflux [VUR] and urinary tract infections [UTI]), need for and type of surgical approach, complications after surgery, and accuracy of prenatal ultrasound in correctly identifying this anomaly. Read More