Ureteral Replacement with Appendix in a Pediatric Group: A Report of Two Cases and Review of the Literature

The reconstruction of long ureteral defect is one of the most difficult procedures in urologic surgeries, especially in children. There are several options available now for urologists to treat ureteral disruption/loss, such as appendix interposition, ileal interposition, psoas hitch, Boari flap, transureteroureterostomy, renal autotransplantation in the right iliac fossa and even nephrectomy. In our opinion, appendix interposition is considered to be a promising method. However, the use of the appendix to restore ureteral continuity has been reported rarely in pediatric age group due to the lack of experience from pediatric surgeons. Herein, we present our experience of using appendix to replace the ureter in pediatric age group.