Extravesical reimplantation of heavily-dilated ureters according to Bradić technique
DOI: https://dx.doi.org/10.18565/urology.2021.3.56-60
M.I. Kogan, I.I. Belousov, V.V. Krasulin, A.A. Gusev
Rostov State Medical University, Rostov-on-Don, Russian Federation
Introduction. Surgery of the ureterovesical anastomoses lesions in case of weakly-dilated ureters is well developed by the Cohen and Lich-Grégoire techniques. However, there are no generally accepted approaches for heavily-dilated ureters. The experience of creating ureterocystoneoanastomosis according to the Bradić technique (1975) for the first time in the literature is presented.
Materials and methods. The authors’ modification of the Bradić technique was used in 12 patients of both sexes with a dilated ureters diameter of more than 10 mm. Two cases of refluxogenic and 10 cases of obstructive megaureter were operated on 2010–2019. The follow-up period was 1–10 years. All patients underwent resection of the ureter in width.
Results. No intraoperative complications were noted. One case of acute pyelonephritis with acute urinary retention was noted as postoperative complications. All patients showed a decrease in dilatation of the pyelocaliceal system and ureter according to multispiral computed tomography after 6 months of follow-up. Two patients had vesicoureteral reflux of the first degree. Glomerular filtration rates decreased in 41.7% of cases after 12 months of follow-up. No recurrence of urinary tract infection and stenosis of the anastomosis was detected for 1-10 years monitoring.
Conclusion. The Bradić technique along with the Hodgson’s ureter reconstruction provides superior results for heavily-dilated ureters in adults.
About the Autors
Corresponding author: Mikhail I. Kogan – Honored Scientist of the Russian Federation, M.D., Dr.Sc.(M), Full Prof.; Head, Dept. of Urology and Human Reproductive Health (with the Pediatric Urology and Andrology Course), Rostov State Medical University, e-mail: dept_kogan@mail.ru
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