Uretero-ureterostomy methods in ureteral duplication: Narrative review of the literature

Abstract

Introduction

The aim of this narrative review is to evaluate the uretero-ureteral anastomosis (UUA) methods applied as a surgical option in duplicated renal systems.

Material and methods

Studies evaluating pediatric patients under 18 years of age who underwent any type of uretero-ureteral anastomosis due to double collecting system were included in the review. The other surgical methods to treat duplex systems such as heminephrectomy, ureteral reimplantation and ureteral clipping were excluded. The studies found by searching the keywords «double collecting system ureter ureteral anastomosis», «double collecting system ureteroureterostomy», «duplex kidney ureter ureteral anastomosis», «duplex kidney ureteroureterostomy» in PubMed. Study design, operative measures, technique of surgery, follow-up time, key results and complications were recorded.

Results

A total of 29 studies from 1967 to 2024 (including 2024) were included in the review. When the studies were analysed, there were no studies comparing the three main UUA procedures (open, laparoscopic and robot-assisted laparoscopic). In studies comparing open and robot-assisted UUA, and laparoscopic versus open techniques, minimally invasive approaches demonstrated shorter hospital stays and comparable outcomes, while operation times were similar across groups.

Discussion

According to the available literature, all of the operative approaches are feasible with high success and low complication rates. However, it is not sufficient to determine the superiority of open, laparoscopic and robot-assisted laparoscopic UUA methods. Prospective comparative studies are required to elucidate the effectivity of different methods to treat duplex systems in children.