Our Summary

This research paper is a review of different methods of uretero-ureteral anastomosis (UUA) surgery, which is a procedure used to treat children with a duplicated renal system, or in simpler terms, two urinary systems in one kidney. The study does not include other treatments for this condition like removal of a part of the kidney, reattachment of the ureter (tube that carries urine from kidney to bladder), and clipping of the ureter.

The researchers looked at 29 studies from 1967 to 2024 that evaluated different surgical methods for UUA in children. They found no studies that compared the three main types of UUA surgery - open surgery, laparoscopic (a less invasive method where small incisions are made), and robot-assisted laparoscopic (which involves a surgeon using a robot to perform the surgery).

In studies that compared open and robot-assisted surgery, and laparoscopic versus open surgery, the less invasive methods resulted in shorter hospital stays and similar outcomes to open surgery. The time taken for the surgery was similar across all methods.

The researchers concluded that all three methods of surgery are feasible with high success rates and low complications. However, they noted that it’s not clear whether one method is better than the others. They suggested that more studies are needed to understand which method is most effective for treating children with a double urinary system in one kidney.

FAQs

  1. What is uretero-ureteral anastomosis (UUA) surgery and who is it used to treat?
  2. What were the findings of the research paper on the different surgical methods for UUA in children?
  3. According to the research, is one surgical method for UUA more effective than the others?

Doctor’s Tip

A doctor might tell a patient who is undergoing ureterostomy surgery to follow all post-operative care instructions carefully, including keeping the stoma (surgical opening) clean and dry, monitoring for any signs of infection or complications, and staying hydrated to promote proper urine flow. It is important to follow up with regular appointments with healthcare providers to ensure proper healing and function of the ureterostomy.

Suitable For

Patients who are typically recommended for ureterostomy include those with:

  1. Duplicated renal system: Patients with two urinary systems in one kidney may require ureterostomy to correct the abnormality and ensure proper urinary flow.

  2. Ureteral strictures: Patients with narrowing or blockages in the ureter may benefit from ureterostomy to bypass the affected area and allow urine to flow freely.

  3. Ureteral injuries: Patients who have sustained damage to the ureter due to trauma or surgery may require ureterostomy to repair the injury and restore normal urinary function.

  4. Ureteral reflux: Patients with a condition where urine flows backward from the bladder into the ureter may need ureterostomy to redirect the flow of urine and prevent further complications.

  5. Congenital anomalies: Patients born with abnormalities in the urinary system, such as vesicoureteral reflux or ureteropelvic junction obstruction, may require ureterostomy as part of their treatment plan.

Overall, patients who are recommended for ureterostomy are those with complex urinary system issues that cannot be effectively treated with less invasive methods. It is important for healthcare providers to carefully evaluate each patient’s condition and determine the most appropriate treatment approach based on their individual needs and circumstances.

Timeline

Before ureterostomy, a patient may experience symptoms such as frequent urinary tract infections, kidney stones, or urinary retention due to a duplicated renal system. They may undergo imaging tests such as ultrasound, CT scan, or MRI to diagnose the condition. Once diagnosed, the patient will consult with a urologist to discuss treatment options.

After ureterostomy surgery, the patient will typically stay in the hospital for a few days for monitoring and recovery. They may experience pain, discomfort, and urinary catheterization post-surgery. Follow-up appointments with the urologist will be scheduled to monitor healing, manage any complications, and discuss long-term care.

Overall, the goal of ureterostomy surgery is to alleviate symptoms, prevent complications, and improve urinary function in patients with a duplicated renal system. Through appropriate treatment and follow-up care, patients can lead a healthier and more comfortable life.

What to Ask Your Doctor

Some questions a patient should ask their doctor about ureterostomy:

  1. What is ureterostomy and why is it being recommended for me?
  2. What are the potential risks and complications associated with ureterostomy surgery?
  3. How long is the recovery process after ureterostomy surgery?
  4. Will I need any additional treatments or follow-up care after the surgery?
  5. Are there any alternative treatments to ureterostomy that I should consider?
  6. How experienced are you in performing ureterostomy surgery?
  7. What is the success rate of ureterostomy surgery for my specific condition?
  8. How will ureterostomy surgery impact my quality of life in the long term?
  9. Are there any lifestyle changes or restrictions I need to follow after the surgery?
  10. Can you provide me with more information or resources about ureterostomy surgery?

Reference

Authors: Keleş M, Harun Kinik A, Selçuk Silay M. Journal: Actas Urol Esp (Engl Ed). 2025 Jul 14:501817. doi: 10.1016/j.acuroe.2025.501817. Online ahead of print. PMID: 40669814