Laparoscopic Ureteroureterostomy and Transvaginal Ureterectomy for Complete Duplicated Ureters

초록

Purpose: To report our experience and the feasibility of transvaginal ureterectomy for refluxing ectopic ureter after laparoscopic ureteroureterostomy. Ureteroureterostomy is a treatment modality for preserving upper pole kidney function in patients with complete duplicated ureters (CDU). Because of the residual ureteral stump, however, the development of urinary tract infection may be a concern. Patients and Methods: We retrospectively reviewed the data of patients with a diagnosis of CDU who underwent surgery between 2007 and 2012. Six female patients with CDU were identified. Of these six patients, four underwent transvaginal ureterectomy after laparoscopic ureteroureterostomy. Results: No patients experienced intraoperative complications. Total mean surgical time in four patients was 250 minutes. Mean laparoscopic ureteroureterostomy time took 180 minutes, and ureterectomy by vaginal incision took 40 minutes, respectively. Mean blood loss was 150 mL. The first patient experienced postoperative complications of mild urine leak and ureteral stricture in the anastomosed site. Conclusions: Our experience suggests that transvaginal ureterectomy after laparoscopic ureteroureterostomy is a minimally invasive modality that may be a technically feasible and effective option for patients who have CDU with refluxing ectopic ureters.

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