Category: Laparoscopy: Upper Tract - Benign

VS8-6 - Laparoscopic upper moiety heminephroureterectomy due to recurrent UTI - diagnostic and procedural challenges

Sat, Sep 22
10:00 AM - 12:00 PM

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.

André Marques-Pinto

Resident
Centro Hospitalar Universitário do Porto
Porto, Porto, Portugal

Manuel Castanheira de Oliveira

Consultant
Centro Hospitalar Universitário do Porto
Porto, Porto, Portugal

Paulo Príncipe

Consultant
Centro Hospitalar Universitário do Porto
Porto, Porto, Portugal

Avelino Fraga

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