Category: Laparoscopy: Upper Tract - Benign

Introduction & Objective : When facing a patient with recurrent urinary tract infections (rUTI), one needs to perform a series of ancillary tests in order to determine whether or not there is an anatomical variation leading to that condition. Duplex collecting systems is a relatively common congenital anomaly, frequently associated with rUTI, flank pain, and obstruction. Symptomatic patients with single atrophic moieties are usually treated with heminephrectomy plus ureterectomy if needed. There is a trend towards minimally invasive techniques. We aim to show the diagnostic and procedural challenges of a laparoscopic procedure in an 35-year-old female presenting with rUTI in the previous 2 years with documented bilateral duplex systems with right upper moiety atrophy and right stenotic ureterocele.

Methods : Collection of clinical data and recordings of the surgical procedure.

Results : As planned, a laparoscopic right upper moiety heminephroureterectomy with ureterocele excision and a Politano-Leadbetter ureteroneocystostomy through a Pfannenstiel incision was performed without any intra- nor post-operatory complications. The procedure lasted 150 minutes, with an estimated 150mL of blood loss. The patient was discharged home on the 3rd post-operative day, and up to the 6th month follow-up visit remains asymptomatic.

Conclusions : Symptomatic duplex systems may require surgery in order to alleviate patients' complaints. This procedure is both safe and effective when performed in experienced hands.

Presenting Author(s)

• AM

  André Marques-Pinto

  – Resident, Centro Hospitalar Universitário do Porto, Porto, Porto, Portugal

Author(s)

• MC

  Manuel Castanheira de Oliveira

  – Consultant, Centro Hospitalar Universitário do Porto, Porto, Porto, Portugal
• PP

  Paulo Príncipe

  – Consultant, Centro Hospitalar Universitário do Porto, Porto, Porto, Portugal
• AF

  Avelino Fraga

  – Department Head, Centro Hospitalar Universitário do Porto, Porto, Porto, Portugal