A Postoperative Observation on Ureteral Reimplantation

Kim, Young Sun; Kim, Si Whang

Abstract

Ureteral reimplantation has been used widely for the correction of ureterovesical reflux, terminal ureteral stricture, ureteral obstruction, ectopic ureteral opening, megaureter, renal transplantation and ureteral injury, etc. The ultimate purpose of the ureteral reimplantation is for the preservation of renal function and upper urinary tract. since the concept of ureterovesical reflux reported by Sampson in 1903, many types of surgical procedure of ureteral eimplantation have been developed and performed for various ureteral obstructive problems. There is also increasing tendency of ureteral reimplantation in out country. To determine the efficacy of ureteral reimplantation, we reviewed and evaluated the records of 34 patients(40 ureters) who underwent ureteral reimplantation at the Department of Urology, Seoul National University Hospital during the period from March, 1979 to February, 1983. And following results were obtained: 1. Ureteral reimplantation was performed in cases of ureterovesical reflux, ureteral stricture, megaureter, bladder tumor, failed previous reimplantation and surgical injury. 2. Thirty two ureters were reimplanted with the method of Politano-Leadbetter, five ureters with Glenn Anderson, one ureter with Cohen and one ureter with transureteroureterostomy with Boari-flap method. 3. Mean duration of ureteral stenting was 6 days(3-10 days). 4. Complications had been observed in 11 cases which included persistent pyuria, persistent reflux, acute pyelonephritis, paralytic ileus, vesicocutaneous fistula and obstruction. 5. Postoperative pyelographic appearances were improved in 10/13(76.9%) cases. We made a conservative treatment in patients with persistent urinary tract infection.