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Robotic-assisted laparoscopic extravesical ureteroneocystostomy for management of adult ureteral duplication with upper pole prostatic urethral insertion.

Larson JA, Tomaszewski JJ, Smaldone MC, Jackman SV - JSLS (2009 Jul-Sep)

Bottom Line: The workup revealed a complete left ureteral duplication with a hydronephrotic upper pole moiety inserting into the prostatic urethra.Clinical follow-up and repeat imaging documented symptomatic and radiographic improvement.Robotic-assisted laparoscopic reconstructive techniques are feasible and efficacious in the management of adult ureteral anomalies.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, University of Pittsburgh School of Medicine, Pennsylvania 15213, USA. larsonja2@upmc.edu

ABSTRACT
A 55-year-old male presented with progressive lower urinary tract symptoms and renal colic. The workup revealed a complete left ureteral duplication with a hydronephrotic upper pole moiety inserting into the prostatic urethra. Using a 5-port transperitoneal robotic-assisted laparoscopic technique, an extravesical upper pole ureteroneocystostomy was performed. Clinical follow-up and repeat imaging documented symptomatic and radiographic improvement. Robotic-assisted laparoscopic reconstructive techniques are feasible and efficacious in the management of adult ureteral anomalies.

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Voiding cystourethrogram obtained on postoperative day number 7 demonstrating no evidence of extravasation from the ureterovesical anastamosis with the ureteral stent in place (a) or the distal ureteral stump on the postvoid film (b).
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Figure 3: Voiding cystourethrogram obtained on postoperative day number 7 demonstrating no evidence of extravasation from the ureterovesical anastamosis with the ureteral stent in place (a) or the distal ureteral stump on the postvoid film (b).

Mentions: The estimated blood loss was less than 20cc, and the total robotic time was 120 minutes. The patient was discharged home without complaint on postoperative day 2. A follow-up voiding cysturethrogram obtained one week postoperatively demonstrated no evidence of extravasation from the anastamosis or the residual ureteral stump (Figure 3), and the Foley catheter was removed. At his 3-month postoperative visit, the patient's voiding symptoms had improved, he had no evidence of flank pain, and his hydronephrosis had resolved on intravenous pyelogram (Figure 4).


Robotic-assisted laparoscopic extravesical ureteroneocystostomy for management of adult ureteral duplication with upper pole prostatic urethral insertion.

Larson JA, Tomaszewski JJ, Smaldone MC, Jackman SV - JSLS (2009 Jul-Sep)

Voiding cystourethrogram obtained on postoperative day number 7 demonstrating no evidence of extravasation from the ureterovesical anastamosis with the ureteral stent in place (a) or the distal ureteral stump on the postvoid film (b).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3015980&req=5

Figure 3: Voiding cystourethrogram obtained on postoperative day number 7 demonstrating no evidence of extravasation from the ureterovesical anastamosis with the ureteral stent in place (a) or the distal ureteral stump on the postvoid film (b).
Mentions: The estimated blood loss was less than 20cc, and the total robotic time was 120 minutes. The patient was discharged home without complaint on postoperative day 2. A follow-up voiding cysturethrogram obtained one week postoperatively demonstrated no evidence of extravasation from the anastamosis or the residual ureteral stump (Figure 3), and the Foley catheter was removed. At his 3-month postoperative visit, the patient's voiding symptoms had improved, he had no evidence of flank pain, and his hydronephrosis had resolved on intravenous pyelogram (Figure 4).

Bottom Line: The workup revealed a complete left ureteral duplication with a hydronephrotic upper pole moiety inserting into the prostatic urethra.Clinical follow-up and repeat imaging documented symptomatic and radiographic improvement.Robotic-assisted laparoscopic reconstructive techniques are feasible and efficacious in the management of adult ureteral anomalies.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, University of Pittsburgh School of Medicine, Pennsylvania 15213, USA. larsonja2@upmc.edu

ABSTRACT
A 55-year-old male presented with progressive lower urinary tract symptoms and renal colic. The workup revealed a complete left ureteral duplication with a hydronephrotic upper pole moiety inserting into the prostatic urethra. Using a 5-port transperitoneal robotic-assisted laparoscopic technique, an extravesical upper pole ureteroneocystostomy was performed. Clinical follow-up and repeat imaging documented symptomatic and radiographic improvement. Robotic-assisted laparoscopic reconstructive techniques are feasible and efficacious in the management of adult ureteral anomalies.

Show MeSH
Related in: MedlinePlus