Abstract Book - 26th ESPU Congress, Joint Meeting with ICCS + SPU + AAP/SOU + AAPU + SFU

11:58 - 12:01

S8-6

(PP)

10 YEAR EXPERIENCE OF UP-FRONT URETERIC REIMPLANTATION FOR PRIMARY

OBSTRUCTED MEGAURETER IN INFANTS AND CHILDREN

Aniruddh DESHPANDE

, Emily JUDE

, Timothy GREER

, Andrew BARKER

, Sophie DOHERTY

, Japinder KHOSA

and

Naeem SAMNAKAY

1) John Hunter Children's Hospital, Staff Specialist in Paediatric Urology and Surgery, Newcastle, AUSTRALIA - 2) Sir

Charles Gairdner Hospital, Intern, Nedlands, AUSTRALIA - 3) Princess Margaret Hospital for Children, Paediatric Surgery,

Subiaco, AUSTRALIA - 4) Princess Margaret Hospital for Children, Paediatric Surgery and Urology, Subiaco, AUSTRALIA -

5) University of Western Australia, Medical Student, Crawley, AUSTRALIA

PURPOSE

It is suggested that Primary Obstructed Megaureter (POM) in infants should be managed with temporising measures,

delaying definitive reimplantation until after age 1 year. This study aims to show that up-front ureteric reimplantation

for POM in infants and children is effective management with minimal morbidity.

MATERIAL AND METHODS

Retrospective review of children with POM (ureter >7mm, with obstructed curve on functional studies or confirmed on

retrograde studies) treated with up-front ureteric reimplantation between 2003 and 2012. Patients with significant

vesicoureteric reflux, posterior urethral valves, duplex ureter, or ureterocoele were excluded. Primary outcome measure

was reoperation for re-stenosis. Secondary outcomes were urinary tract infection, impaired renal function, and

incontinence. Median post-operative follow-up was 55.2 months (range: 1.4 – 135.2 months).

RESULTS

42 patients had POM. 21 (50%) were detected on antenatal ultrasound. 20 presented with UTI and 1 was incidentally

diagnosed. 3 (7%) had bilateral POM, and 3 (7%) had POM in a solitary kidney. Median age at reimplantation was 6.7

months (range: 0.1 – 131.1 months). 19 (45%) were12 months. 21 (50%) underwent tapering. Only 3 patients (7%)

required repeat reimplantation due to recurrent VUJ obstruction, 2 of whom had the original reimplantation at ages 5

and 9 years respectively. Median time to reoperation was 3.3 years. Secondary outcomes showed that 14 (33%)

patients developed post-operative UTI, 5 (12%) developed urinary incontinence, and 3 (7%) developed impaired renal

function.

CONCLUSIONS

Up-front ureteric reimplantation is a safe and effective option for infants and children with POM.