Long-term Result in Ureteroneocystostomy for Complete Duplicated Ureters in Renal Transplantation

Abstract

Duplicated ureters are the most common congenital malformation of the upper urinary tract, but there are few reports on the transplantation of kidneys with duplicated ureters. We introduce different techniques for the ureteroneocystostomy of double ureters and long-term results. We specifically detail the experience of two patients with duplicated ureters at Bong Seng Memorial Hospital from March 1995 to May 2012. In our first case, the top technique of spatulating and suturing duplicated ureters was applied with the bottom technique for double ureteroneocystostomy. The operation time was 4 hours and 45 minutes, while the ureteroneocystostomy took 32 minutes. In the second case a double-armed 4.0 Vicryl suture was placed on each tip of the ureter and both needles passed from the inside out through the bladder wall. The ureters were pulled into the bladder and the suture was tied on the serosa of the bladder. The operation time was 3 hours and 50 minutes, while the ureteroneocystostomy took 15 minutes. Neither urological complications nor urinary tract infections were observed in the follow-up period and no double-J stent was needed. We therefore conclude that these two techniques are available procedures for handling duplicated ureters, with the technique applied in the second case particularly time-effective.