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Distal ureteral atresia: Recovery of renal function after relief of obstruction at ten months old
Author(s) -
ASHIMINE SATOSHI,
MIYAZATO MINORU,
HAYASHI EIRI,
MOROZUMI MAKOTO,
SUGAYA KIMIO,
OGAWA YOSHIHIDE
Publication year - 2005
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.2005.01103.x
Subject(s) - medicine , hydronephrosis , ureter , surgery , renal function , nephrostomy , pyelogram , atresia , urinary diversion , abdomen , ureterostomy , urinary system , urology , anatomy , percutaneous , bladder cancer , cancer , cystectomy
A large cystic mass that occupied more than half of the abdomen was identified by ultrasound in a 10‐month‐old boy. Intravenous pyelography failed to visualize the right kidney, so we created a loop ureterocutaneostomy followed by temporary nephrostomy to improve renal function. Exploratory surgery revealed complete atresia of the distal right ureter. A ureteral stricture developed after ureteroneocystostomy and undiversion of the loop, so a second reconstruction procedure was required (pelvi‐ureteroplasty and reimplantation of the right ureter with a psoas hitch) to free the patient from dependence on catheters. Despite the occurrence of giant hydronephrosis secondary to complete ureteral obstruction at the age of 10 months, the function of the right kidney could be preserved. Accordingly, aggressive attempts to promote functional recovery may be justified even when patients have advanced hydronephrosis.