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Journals / Pediatric Practice and Research / 2026 / Volume: 14 Issue: 1

Mid-Term Outcome of Distal Ureteral Stump after (Hemi)Nephroureterectomy

(Hemi)Nefroüreterektomi Sonrası Distal Üreter Güdüğünün Orta Vadeli Sonuçları

Süleyman Tağcı(Ankara Bilkent City Hospital)0000-0002-5763-8916
Gunay Ekberli(Ankara Bilkent City Hospital)0000-0002-0021-5998
Bilge Karabulut(Ankara Bilkent City Hospital)0000-0002-5113-7467
Tuğrul Tiryaki(Ankara Bilkent City Hospital)0000-0002-9544-1137
Pages
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Publication Date
2026-08-02
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Therefore, the residual ureter should not be left during NU, especially in cases with VUR.

📌 3 Key Takeaways

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Objective & Hypothesis:Aims: The complete removal of the ureter minimises the risk of future morbidity associated with the distal ureteral stump (DUS), including febrile urinary tract infections (UTIs), lower quadrant pain and haematuria – the so-called ureteral stump syndrome (USS).
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Key Findings & Data:Methods: Between July 2008 and April 2019, 29 patients, with a mean age of 4.7 years, underwent (H)NU for poorly functioning dysplastic, scarred, atrophic or hydronephrotic kidneys.
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Conclusion & Impact:Therefore, the residual ureter should not be left during NU, especially in cases with VUR.
🔬Design:Research Article
📍Scope:2008 Verileri
⚙️Variables:ureteral stump syndrome · distal ureteral stump · heminephrectomy

Abstract

Aims: The complete removal of the ureter minimises the risk of future morbidity associated with the distal ureteral stump (DUS), including febrile urinary tract infections (UTIs), lower quadrant pain and haematuria – the so-called ureteral stump syndrome (USS). This research evaluated the mid-term outcome of DUS after (hemi)nephroureterectomy ((H)NU). Methods: Between July 2008 and April 2019, 29 patients, with a mean age of 4.7 years, underwent (H)NU for poorly functioning dysplastic, scarred, atrophic or hydronephrotic kidneys. Twenty-two patients received total NU, and seven patients received HNU. In all patients, with or without vesicoureteral reflux (VUR), the ureteral stump was ligated. Results: Heminephroureterectomy was applied to three patients for upper pole moieties (one with an ectopic ureter and two with ureteroceles) and to four patients for lower pole moieties with high-grade VUR. Total NU procedures were performed for nephrolithiasis, ureteropelvic junction obstruction, xanthogranulomatous pyelonephritis, multicystic dysplastic kidneys (MCDKs) and high-grade VUR. Distal ureteral stump resection was required in two patients for USS during the mean 1.5-year follow-up period. Both patients had undergone total NU operations because of high-grade VUR and poorly functioning, dysplastic, scarred kidneys. Conclusion: In this series, USS was seen in only two patients (28.6%) with high-grade VUR in the total NU group. The authors, therefore, believe that high-grade VUR is more important than ureteral stump length and stump ligation for USS development. Therefore, the residual ureter should not be left during NU, especially in cases with VUR.

Özet

Amaç: Üreterin tamamen çıkarılması, distal üreter güdüğü (DÜG) ile ilişkili gelecekteki morbidite riskini; febril üriner sistem enfeksiyonları (ÜSE), alt kadran ağrısı ve hematüriyi içeren ve üreter güdüğü sendromu (ÜGS) olarak adlandırılan tabloyu en aza indirir. Bu çalışmada, yazarların gerçekleştirilen (hemi)nefroüreterektomi [(H)NÜ] sonrası DÜG’nin orta dönem sonuçları değerlendirildi. Metod: Temmuz 2008 ile Nisan 2019 tarihleri arasında, ortalama yaşı 4,7 yıl olan 29 hastaya kötü fonksiyon gösteren displastik, skarlı, atrofik veya hidronefrotik böbrek nedeniyle (H)NÜ uygulandı. Yirmi iki hastaya total NÜ, yedi hastaya ise HNÜ uygulandı. Vezikoüreteral reflü (VUR) varlığına bakılmaksızın tüm hastalarda üreter güdüğü bağlandı. Bulgular: Heminefroüreterektomi; üç hastada üst pol sistemine (bir ektopik üreter ve iki üreterosel) ve dört hastada yüksek dereceli VUR bulunan alt pol sistemine uygulandı. Total NÜ işlemleri; nefrolitiazis, üreteropelvik bileşke darlığı, ksantogranülomatöz piyelonefrit, multikistik displastik böbrekler (MKDB) ve yüksek dereceli VUR nedeniyle gerçekleştirildi. Ortalama 1,5 yıllık takip süresi boyunca iki hastada ÜGS nedeniyle distal üreter güdüğü rezeksiyonu gerekti. Bu iki hastanın da yüksek dereceli VUR ve kötü fonksiyon gösteren displastik, skarlı böbrek nedeniyle total NÜ operasyonu geçirdiği görüldü. Sonuç: Bu seride ÜGS yalnızca total NU grubunda yer alan ve yüksek dereceli VUR bulunan iki hastada (%28,6) gözlendi. Bu nedenle yazarlar, ÜGS gelişiminde yüksek dereceli VUR’un, üreter güdüğü uzunluğu ve güdük ligasyonundan daha önemli olduğunu düşünmektedir. Bu nedenle özellikle VUR bulunan olgularda NÜ sırasında rezidüel üreter bırakılmamalıdır.

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Cite This Article

Tağcı, S., Ekberli, G., Karabulut, B., Tiryaki, T. (2026). Mid-Term Outcome of Distal Ureteral Stump after (Hemi)Nephroureterectomy. Pediatric Practice and Research, Volume: 14 Issue: 1. https://doi.org/10.21765/pprjournal.1956229

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