TREATMENT OF CONGENITAL MIDURETERAL STENOSIS IN CHILDREN USING LAPAROSCOPY: A SERIES OF CASES STUDY

Midureteral stenosis in children is very rare. The authors report about patients with this ureteral anomaly who have underwent surgery by the same surgeon, operated in different surgical clinics with focus on differences in preoperative diagnosis and treatment compared to other congenital obstructive uropathy. Materials and methods: the study presents the data about 5 patients diagnosed with congenital stenosis of the middle third of the ureter who have underwent surgery between January, 2017 and December, 2021. In the final part of the study the methods of preoperative examination, surgical parameters and results of postoperative observation were noted as well. Results: the midureteral stenosis was observed in 3 (60%) boys and 2 (40%) girls. The anomaly occurred on the left side in 3 (60%) patients and on the right side in 2 (40%) patients. 3 (60%) patients were under the age of 6 months old and 2 (40%) patients were under the age of 1 year old. Prior to the surgical intervention all patients have underwent ultrasonic examination of kidneys as well as multi-spiral computed urography. The diagnostic value of ultrasound was 80%, and of computed urography – 100%. All patients have undergone laparoscopic resection of the stenosis site coupled with anastomosis. The average duration of hospital stay was 5.0±0.7 days (5.0 [4.5; 5.5] days as median). The average duration of follow-up was 30.6±22.5 months (30.0 [9.0; 52.5] months as median). The urinary tract obstruction was stopped without long-term complications in all patients. Conclusion: the midureteral stenosis in children is a rare disease. Its treatment mainly consists of resection of the stenotic segment followed by the imposition of an end-to-end type of ureteral anastomosis with favorable prognosis.