Congenital midureteral strictures are a rare cause of obstructive uropathy in children. There are only a few reports of successful laparoscopic treatment for this disease. We present a description of our own experience using laparoscopy to correct congenital ureteral stenosis in the middle third in one infant.

MATERIALS AND METHODS

Laparoscopic treatment of congenital mid-ureteral strictures was performed in a boy aged 2 months. The patient’s weight was 4200 grams. Preoperative visualization of stricture included an ultrasound examination of the upper urinary tract and intravenous urography. Ultrasound and x-ray examination of the upper urinary tract showed an expansion of the upper third of the left ureter to 15 mm. The size of the pelvis of the left kidney was 20 mm. Before surgery was performed cystoscopy with the placement of ureteral JJ-stent in the pelvis of the left kidney. A laparoscopic stricture excision was performed with creation of ureteroureteroanastomosis. The stent was removed after 4 weeks. Follow-up included clinical observation and ultrasound examination for 12 months after surgery.

RESULTS

Laparoscopic restoration of ureteral patency was performed successfully without complications during the operation. The duration of the procedure was 60 minutes, including cystoscopy and stenting of the ureter. After stent removal, no expansion of the pelvis and the upper third of the ureter were noted, that is, signs of obstructive uropathy disappeared without a trace.

CONCLUSION

Laparoscopic ureteroureteroanastomosis is a safe and effective method of treatment of congenital stricture of the middle part of the ureter, which minimizes the physiological and cosmetic effects of the operation on the infant’s body.