V09-10 URETERAL SIDE-TO-SIDE ANASTOMOSIS FOR TRANSECTING INJURY OF COMPLETELY DUPLICATED COLLECTING SYSTEM

Abstract

You have accessJournal of UrologyUpper Tract Reconstruction (V09)1 Sep 2021V09-10 URETERAL SIDE-TO-SIDE ANASTOMOSIS FOR TRANSECTING INJURY OF COMPLETELY DUPLICATED COLLECTING SYSTEM Randall Lee, Aeen Asghar, David Strauss, Michael Metro, and Daniel Eun Randall LeeRandall Lee More articles by this author , Aeen AsgharAeen Asghar More articles by this author , David StraussDavid Strauss More articles by this author , Michael MetroMichael Metro More articles by this author , and Daniel EunDaniel Eun More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002052.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Iatrogenic injuries commonly occur at the distal ureter. The gold standard for distal ureteral injury is ureteroneocystotomy, however new techniques such as side-to-side (StS) anastomosis have demonstrated safe and comparable outcomes. In a duplicated collecting system, two ipsilateral ureters may drain the kidney into the bladder independently or as a single common ureter which may complicate preoperative planning for ureteral reconstruction. Currently limited literature exists regarding iatrogenic distal ureteral injuries to duplicated collecting systems. METHODS: 51 year old female with a history of left robot assisted hysterectomy which was complicated by flank pain post operatively. Imaging work up revealed a duplicated left collecting system with left hydronephrosis concerning for ureteral injury and obstruction. After failed ureteral stent placement patient underwent percutaneous nephrostomy drainage of both left renal moieties. Patient was evaluated and scheduled for a robotic ureterolysis and reconstruction, and ultimately underwent a robotic assisted side-to-side anastomosis and ureteroneocystotomy as described in our video. RESULTS: Total console time was 241 minutes with an estimated blood loss of 150 mL. There were no intraoperative complications. Patient was discharged with ureteral stent and foley on post operative day one. On follow up, patient with no clinical or radiographic evidence of left ureteral obstruction. CONCLUSIONS: We demonstrate that robot-assisted StS ureteral anastomosis with an intravesical non-refluxing ureteroneocystotomy in a duplicated collecting system is a safe and effective option. This technique allows maximal preservation of ureteral perfusion and reimplantation of one ureter. ICG helps facilitate ureteral dissection and assess ureteral blood supply intraoperatively to aid in successful reconstruction. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e690-e690 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Randall Lee More articles by this author Aeen Asghar More articles by this author David Strauss More articles by this author Michael Metro More articles by this author Daniel Eun More articles by this author Expand All Advertisement Loading ...