EXTRAVESICAL DETRUSORRHAPHY FOR REFLUXING URETERS ASSOCIATED WITH PARAURETERAL DIVERTICULA

Objectives. To demonstrate the effectiveness of an extravesical approa ch to refluxing ureters associated with paraureteral diverticula. Meth ods. Over a 39-month period, 23 children underwent repair of Hutch div erticula with refluxing ureters using an extravesical approach. Sevent een had unilateral reflux with an ipsilateral diverticulum, 4 had bila teral reflux with a unilateral diverticulum, and 2 had bilateral reflu x with bilateral diverticula. Overall, 25 ureters with associated dive rticula were repaired. Results. Twenty ureters were repaired with a no ndismembered technique and 5 with a dismembered technique. Twenty-two of the 23 patients (96%) were successfully repaired with this approach . Three patients had transient reflux postoperatively, which resolved spontaneously within 6 months. One patient who underwent bilateral dis membered procedures for bilateral diverticula has persistent unilatera l grade II reflux postoperatively. No patient developed ureteral obstr uction. Conclusions. The major advantage of this technique is seen in the minimal postoperative morbidity. The extravesical approach is a sa fe, simple, and effective method for the management of a refluxing ure ter with an associated diverticulum.