Surgical management of upper pole nonfunctioning renal moieties – the timeless debate
Treatment options for obstructed upper pole non-functioning moieties in duplicated systems vary significantly. Traditionally, an upper pole heminephrectomy was favored to avoid any potential morbidity from the nonfunctioning moiety. However, the concomitant presence of lower urinary tract obstruction from ureterocele and lower pole vesicoureteral reflux (VUR), have pushed many to argue for performing only a common sheath reimplantation without an upper pole heminephrectomy. We evaluate the surgical management and outcomes of such patients treated at our institution.
In this retrospective IRB-approved study, patients undergoing upper pole heminephrectomy, ureteroureterostomy or common sheath ureteral reimplantation from 2012-2017 were identified by CPT codes. Only patients with decreased upper pole function, classified as