Upper Pole Heminephrectomy Versus Lower Pole Ureteroureterostomy for Ectopic Upper Pole Ureters

• Published in: Current urology reports Vol. 18; no. 3; p. 21
• Main Authors: Michaud, Jason E., Akhavan, Ardavan
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.03.2017
• Subjects: Humans; Medicine; Medicine & Public Health; Nephrectomy; Nephrology; Pediatric Urology (D Weiss; Section Editor; Topical Collection on Pediatric Urology; Ureteral Obstruction - complications; Ureteral Obstruction - pathology; Ureteral Obstruction - surgery; Urologic Surgical Procedures; Urology; Vesico-Ureteral Reflux - etiology; Heminephrectomy; Ureteral duplication; Ureteroureterostomy; Ureterocele; Vesicoureteral reflux; Ectopic ureter
• ISSN: 1527-2737; 1534-6285; 1534-6285
• DOI: 10.1007/s11934-017-0664-0

Purpose of Review Ureteral duplication and ectopic upper pole ureters are commonly associated with renal pathology, including vesicoureteral reflux, obstruction, infection, and renal function loss. There remains no consensus on the most appropriate management of these complex patients. In this review, we sought to compare existing data on upper pole heminephrectomy with ipsilateral ureteroureterostomy. Recent Findings Application of magnetic resonance imaging and minimally invasive techniques have led to changes in the diagnosis and treatment of ectopic upper pole ureters. Recent studies have highlighted the safety of laparoscopic and robot-assisted upper pole heminephrectomy and ureteroureterostomy. Summary Minimally invasive approaches to ectopic upper pole ureters appear safe and effective, with complication rates remaining low. Minimally invasive upper pole heminephrectomy carries a higher risk of lower pole function loss. Both upper pole heminephrectomy and ureteroureterostomy carry a small risk of additional surgery on the bladder and remnant ureter.