Uretero-uretero anastomosis: una alternativa para pacientes con patología asociada a doble sistema colector

Abstract

Introduction: Double collecting system is the most common renal impairment and recorded an incidence of 1/500. There are different treatment options available for the severely dilated uréter or reflux associated with a duplicate system, including uretero-uretero anastomosis. Our objective is to present our experience in performing the uretero-uretero anastomosis as an alternative for patients with this pathology. Materials and methods: A case series study was performed between January 2010 and April 2014. The medical records of 214 patients with double collecting system and associated disorders were reviewed, 10 patients underwent uretero-uretero anastomosis. The follow-up period was 12 months average. Results: A total of 10 patients were enrolled 70% were women, the average age of patients at the time of surgery was 5 years. All of them fab urinary tract infection and 10% patient had permanent urinary incontinente. Forty percent had a diagnosis of ectopic uréter, 30% patients had intravesical ureterocele and 30% had vesicoureteral reflux to the lower system. Seven upper to the lower anastomosis system and three inferior to superior were made. All were made by 2cm inguinal incision, all patients were derived with double J stent. At follow-up, all patients were without antibiotic prophylaxis, resolved hydronefrosis, without urinary infections and without incontinence. Conclusions: The uretero-uretero anastomosis is a reliable, secure and low morbidity alternative for the treatment of patients with double collector system associated pathology. Additional studies with larger numbers of patients and follow-up will be needed to see long-term evolution.