Abstract：
OBJECTIVES:To share our experience with nondismembered ureteroplasty (NDU), a novel application of an old technique in congenital midureteral stenosis (CMS). METHODS:A 35-year-old man was diagnosed as a case of CMS, a rare benign condition on the basis of extensive evaluation, including ultrasonography, intravenous urography, ethylenedicystine renal scan, antegrade and retrograde contrast study of the left kidney and ureter, and a 64-slice computed tomographic angiography of the abdomen with 3-dimensional reconstruction. He was managed by open NDU, where a longitudinal incision over the narrowed segment was closed transversely using the Heineke-Mikulicz principle, thereby preserving the midureteral blood supply, which is considered tenuous. RESULTS:The patient had a successful outcome and is asymptomatic at 1-year follow-up, with significant resolution of hydroureteronephrosis on ultrasonography, and a nonobstructed left kidney with 37% differential renal function on renal scan. CONCLUSIONS:Nondismembered ureteroplasty is a meticulous surgical technique emphasizing blood supply preservation; it can be a useful option in relatively long-segment CMS and adds another method in the surgeon's armamentarium for repairing this rare condition. This technique can be especially useful during laparoscopic or robotic repair of such stenosis.
journal_name
Urologyjournal_title
Urologyauthors
Goel A,Singh D,Sengottayan VK,Sankhwar Sdoi
10.1016/j.urology.2010.03.093subject
Has Abstractpub_date
2010-10-01 00:00:00pages
1004-6issue
4eissn
0090-4295issn
1527-9995pii
S0090-4295(10)00759-4journal_volume
76pub_type
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