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Laparoscopic Extravesical Management of Single-System Ectopic Ureters in Children: A Case Series of Four Patients
Sarra Chennouf, Aida el Gouacem, Hichem Choutri, Amina Bensebti, Zoubir Atrih
Boubnider University constantine3, Faculty of medecine, Department of pediatric surgery SMK Constantine
Background:
Single-system ectopic ureter (SSEU) is a rare urological anomaly, frequently misdiagnosed due to its subtle and nonspecific clinical presentation in children. Early and accurate diagnosis is essential to preserve renal function and prevent long-term complications. The laparoscopic extravesical ureteral reimplantation technique has emerged as a promising minimally invasive surgical option in pediatric urology.
Objective:
To evaluate the diagnostic challenges and surgical outcomes of laparoscopic extravesical management in four pediatric cases of single-system ectopic ureter.
Methods:
Between 2019 and 2025, four children (2 girls, 2 boys) aged between 9 months and 15 months were diagnosed with SSEU based on a combination of ultrasound, VCUG, MRU, and renal scintigraphy. All patients underwent laparoscopic extravesical ureteral reimplantation under general anesthesia. Operative time, intraoperative findings, postoperative complications, and follow-up data were analyzed.
Results:
All procedures were completed successfully without conversion to open surgery. The mean operative time was 250 minutes. No intraoperative complications were noted. Postoperative recovery was uneventful in all cases, with hospital discharge occurring within 48–72 hours. At 6 to 12 months of follow-up, all patients were continent, and renal function was preserved or improved. Imaging confirmed satisfactory positioning of the reimplanted ureters and resolution of hydronephrosis when present.
Conclusion:
Laparoscopic extravesical reimplantation is a safe, feasible, and effective technique for managing single-system ectopic ureters in children. It provides excellent functional outcomes with minimal morbidity. This case series highlights the importance of early diagnosis and supports the use of minimally invasive approaches in pediatric urologic surgery.