Complicated ureteroceles with non-functioning renal moieties in duplex kidneys: One-stage radical laparoscopic treatment

Abstract

The optimal management of large ectopic extravesical ureteroceles that are associated with a non-functioning renal moiety in a duplex system has remained a challenging problem and the focus of continuing controversies. Traditional surgical management strategy for this condition usually consists of a two-stage open approach. The first stage entails removal of the nonfunctioning renal moiety, usually the upper pole of the kidney, and excision of the dilated upper moiety ureter, via a muscle-cutting flank incision. The second stage involves the excision of the lower end of the dilated ureter together with the ectopic ureterocele, reconstruction of the resulting defect in the bladder base and bladder neck, and reimplantation of the normal lower moiety orthotopic ureter to prevent subsequent vesicoureteric reflux. Excellent long-term results have been reported by various workers using this approach. However such management strategy necessitates two major abdominal operations via large open incisions, usually during two separate hospital admissions in quick succession. © Springer-Verlag Berlin Heidelberg 2008.