Our Experience of Ureteral Substitution in Pediatric Age Group

Objectives To find appropriate ureteric substitute in the pediatric age group. Methods Retrospective analysis was done from 2003 to 2008 of all patients operated in our hospital who had undergone ureteric replacement. All cases were followed up to find conduit patency, renal function, and any related complication. Results Ureteric replacement was performed in 5 cases. Age of the patients ranged from 6 months to 9 years. Three cases were of obstructive megaureter; 1 of redo-pyeloplasty and 1 of iatrogenic injury of the ureter. Three patients underwent partial ureteric substitution of the right ureter, and complete replacement of the left ureter with appendix was performed in 1 patient. In 1 case small bowel was used as Monti tube to substitute the ureter. At median follow-up of 23 months (14-66 months) all patients were well except 1 whose kidney function had deteriorated. Conclusions We believe that our small series supports that either appendix or small bowel should be considered as Monti's tube for ureteric replacement when confronting with short ureter in pediatric age group.