Ureterocystoplasty: An alternative reconstructive procedure to enterocystoplasty in suitable cases

Purpose: The objective of the report is to present the results of ureterocy stoplasty in 6 children with megaureters and low-capacity, high-pressure bl adders, Methods: Of the 6 patients, 2 had valve bladders, 1 had Hinmann's syndrome, 1 had neuropathic bladder, and the remaining 2 with ureterocutaneostomy we re mainly diverted because of refluxing megaureters. Nephrectomy was perfor med in both of the boys with posterior urethral valve because of vesicouret eral reflux dysplasia (VURD) syndrome, and the ipsilateral ureter was used for the augmentation. In 2 patients with ureterocutaneostomy and in 1 with Hinmann's syndrome, a transureteroureterostomy was carried out, and the dis tal part of the ureter was used to perform augmentation. The patient with n europathic bladder had a nonfunctioning crossed ectopic left kidney with an associated ipsilateral, refluxing mega ureter, and the ureter was used for aug mentation after the nephrectomy. Results: All of the patients are continent, and 4 patients who are neurolog ically normal void spontaneously without requiring clean intermittent cathe terization (CIC). The average increase in bladder capacity is 263% (range, 190% to 340%), Conclusions: Ureterocystoplasty is the bladder augmentation of choice for p atients with a nonfunctioning kidney with an associated ipsilateral, reflux ing megaureter and for patients with kidneys both in good function and mega ureters suitable for a transureteroureterostomy. Copyright (C) 2000 by W.B. Saunders Company.