Table 1.
Case number | Age/sex | Diagnosis | Investigations | Surgical procedure | Operating time | Estimated blood loss | Hospital stay | Outcome at 1 year |
---|---|---|---|---|---|---|---|---|
Case 1 | 3 years, male | Bilateral primary VUR, left PFK | USG: Right kidney - 5.4 cm with raised echoes. Left kidney - 9.3 cm, gross hydroureteronephrosis with marked cortical thinning VCUG: Bilateral VUR (left - grade 5, right - grade 2), bladder capacity 210 mL DMSA: Left kidney 23%, scars + | Robotic bilateral intravesical ureteric reimplantation with excisional tapering of the left ureter | 180 min | 50 mL | 5 days | Resolution of VUR; no UTI |
Case 2 | 12 years, male | Left PFK with grade V VUR | Contrast-enhanced CT: Gross left hydroureteronephrosis up to the lower end of the ureter DMSA: Left PFK (30%), scars + VCUG: Left grade 5 VUR; bladder capacity 450 mL | Robotic intravesical left ureteric reimplantation with excisional tapering | 200 min | 35 mL | 5 days | Resolution of VUR; no UTI |
Case 3 | 12 years, male | Bilateral grade 5 VUR | USG: Bilateral gross hydroureteronephrosis; left distal ureter - 2 cm, right distal ureter - 1.8 cm VCUG: Bilateral grade 5 VUR; bladder capacity 550 mL DMSA: Left kidney 60%, right kidney 40% | Robotic bilateral intravesical ureteric reimplantation with Cohen’s technique and tapering of the left ureter | 210 min | 50 mL | 6 days | Resolution of VUR; no UTI |
Case 4 | 6 years, female | Right PFK with ectopic ureter and grade 5 VUR | USG: Small right kidney (5.5 cm × 2.3 cm) with moderate hydroureteronephrosis) VCUG: Right grade 5 VUR; bladder capacity 250 mL DMSA: Right kidney 17%, scars + | Robot right intravesical ureteric reimplantation with tapering of the right ureter | 200 min | 40 mL | 5 days | Resolution of VUR; no UTI |
DMSA: Dimercaptosuccinic acid, PFK: Poorly functioning kidney, USG: Ultrasonography, UTI: Urinary tract infection, VCUG: Voiding cystourethrogram, VUR: Vesicoureteral reflux, CT: Computed tomography