Letter to the Editor

tempting. On one hand, the morbidity associated with a perfo-

RE: Obaidah et al.: Our Experience of
Ureteral Substitution in
Pediatric Age Group (Urology
2010;75:1476-1480)
TO THE EDITOR:
The authors are to be congratulated on rescuing the 5 patients
and restoring the urinary tract continuity. The surgical chal-
lenges which were encountered are well described and illus-
trated. The surgical alternatives are discussed and reviewed.
Although individual surgeons may vary in their choice of ure-
teral replacement, one cannot argue with a successful outcome.
This is yet another article illustrating the versatility of the
appendix.
The vermiform appendix and the Yang-Monti intestinal re-
configuration into a conduit are firmly established in the uro-
logic armamentarium. Their multiple uses are well described. It
may be time to make a strong case for preserving the appendix
in newborns and infants with congenital upper or lower urinary
tract structural anomalies. Many undergo surgical exploration
for associated anomalies, and an incidental appendectomy is
rated appendix–– especially in an infant with multiple anoma-
lies––is significant. Although the incidence of primary appen-
diceal disease during a lifetime is low (with carcinoid tumors
leading the way), one can argue that an incidental appendec-
tomy might prevent future morbidity. This alternative has to be
weighed against the potential benefit of appendiceal preserva-
tion as a ureteral substitute or a conduit for catheterization.
However, because of the low prevalence of these anomalies and
length of the period during which a preserved appendix repre-
sents a risk to the patient, it may be difficult to anticipate
evidence from the published data in favor of one approach or
the other. Suffice it to say that there have been, thus far, no
reports of malignancies developing in appendiceal segments
incorporated into the urinary tract.
Hrair-George O. Mesrobian, M.D., M.S., Children’s Health
Systems, Medical College of Wisconsin, Milwaukee,
Wisconsin
doi:10.1016/j.urology.2009.08.070
UROLOGY 76: 255, 2010. © 2010 Published by Elsevier
Inc.

Erratum

The Letter to the Editor published in this issue, “Re: Obaidah et al.: Our
Experience of Ureteral Substitution in Pediatric Age Group (Urology 2010;
75;1476-1480) was an Editorial Comment that should have been published in
the June issue with the article, “Our Experience of Ureteral Substitution in
Pediatric Age Group” by Abu Obaidah, Shivaji B. Mane, Nitin P. Dhende,
Himanshu Acharya, Nitin Goel, Ashok A. Thakur, and Jamir Arlikar. The
incorrect Editorial Comment by Dominic Frimberger ran with that article,
and has been published again in this issue on page 8, paired correctly with
“Perioperative Risk Factors for Surgical Complications in Pediatric Urology:
A Pilot Study in Preoperative Risk Assessment in Children” by Drew A.
Freilich, Bartley G. Cilento Jr., Dionne Graham, Jing Zhou, Alan B. Retik,
and Hiep T. Nguyen. Our sincere apologies for this error.

© 2010 UROLOGY 76: 255, 2010 • 0090-4295/10/$34.00 255

All Rights Reserved doi:10.1016/j.urology.2009.08.070