Repeated operations on the ureterovesical segment in children with ureteral length deficiency

Introduction. Despite the effectiveness of various methods of reimplantation of the ureter in various forms of pathology of the ureterovesical segment in children, a number of patients require repeated reconstruction. At the same time, there are situations when the length of the mobilized ureter is insufficient for transverse ureterocystoneoimplantation with the formation of the ureteral mouth in the area of the Lieto triangle. The question remains about the choice of a technique for the formation of ureterocystoanastomosis in conditions of a deficit in the length of the ureter. The aim: to determine the effectiveness of various methods for repeated reimplantation of the ureter in children.

Materials and methods. In the department of urology and andrology, in the period from 2016 to 2025, repeated laparoscopic ureterocystoneoimplantation was performed in forty patients, on 45 ureters. The age of the children ranged from 10 months to 16 years (63.8 ± 45.7 months). The patients were divided into 2 groups. Group 1 included 12 children who underwent laparoscopic transverse extravesical reimplantation (14 reimplanted ureters). Group 2 included 28 patients who underwent laparoscopic longitudinal extra-intravesical ureterocystoneoimplantation (31 reimplanted ureters). The follow-up period is from 6 months to 9 years.

Results. In patients who underwent laparoscopic transverse extravesical ureterocystoneoimplantation, vesicoureteral reflux was detected in 5 out of 14 reimplanted ureters. Due to the loss of kidney function, two children underwent nephrectomy. In patients with laparoscopic longitudinal extra-intravesical ureterocystoneoimplantation, vesicoureteral reflux was detected in 4 out of 31 reimplanted ureters. Violations of the evacuation function of the vesicoureteral segment in the postoperative period were not detected in patients from both groups.

Conclusion. The high efficiency of laparoscopic longitudinal extra-intravesical ureterocystoneoimplantation in children with repeated interventions, including conditions of ureteral length deficiency, has been established.

Contribution:
Sharkov S.M. — concept and design of the study;
Margieva D.A., Shmyrov O.S., Kulaev A.V., Surov R.V., Lobach P.Yu. — collection and analysis of the material, writing the text;
Lazishvili M.N., Morozov K.D., Kovachich A.S., Lobach A.Yu. — editing the text.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: October 30, 2025
Accepted: November 27, 2025
Published: December 25, 2025

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