WOFAPS 2025 8th World Congress of Pediatric Surgery

Tunç Tığlı, İdil Rana user kılıç, Burak Ardıçlı, İbrahim Karnak, Saniye Ekinci

Department of Pediatric Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkiye

Purpose:
Ureterocutaneostomy is a safe and effective temporary urinary diversion method for pediatric patients with complex obstructive uropathies, particularly in infancy when adequate drainage cannot be achieved. This study aims to evaluate the clinical features and short-term outcomes of patients who underwent this procedure in our center.

Methods:
Medical records of eight pediatric patients who underwent ureterocutaneostomy were retrospectively reviewed. Data including sex, age at surgery, diagnosis, surgical indications, imaging findings, and early postoperative course were analyzed. Postoperative follow-up was conducted with ultrasonography (USG), DMSA, and MAG3 renal scintigraphy.

Results:
Seven of the patients were male and one was female. All except one patient were younger than one year at the time of surgery. The exception was a 5-year-old boy who presented late with high-grade vesicoureteral reflux and demonstrated early improvement in infection control and renal function after ureterocutaneostomy. Diagnoses included posterior urethral valve (n=3), high-grade vesicoureteral reflux (n=3), prune belly syndrome (n=1), Hutch diverticulum (n=1), and bladder exstrophy with ureterovesical junction obstruction (n=1). Surgical indications were recurrent urinary tract infections, high-grade reflux, upper tract dilatation, bladder dysfunction, and renal impairment. Imaging findings commonly included hydronephrosis, ureteral dilatation, and cortical thinning. Most patients achieved infection control and renal stabilization in the early postoperative period. Additional interventions such as nephrostomy or peritoneal dialysis catheter placement were planned in selected cases. No major perioperative complications were observed.

Conclusion:
Ureterocutaneostomy is an effective and reliable temporary urinary diversion in infants with severe obstructive uropathy. When performed in the appropriate setting, it plays a valuable role in achieving clinical stabilization before definitive reconstructive surgery.