A single procedure that definitively treats all problems of a ureterocele can be selected in more than three-quarters of patients. Transurethral incision was unsuccessful at definitively treating these patients in our experience. An isolated upper tract procedure was successful in patients with no or mild associated vesicoureteral reflux. We think that upper tract surgery should be the procedure of choice in this subset of patients, as it usually resolves the problem and does not subject the patient to the potential morbidities of bladder surgery. Although total reconstruction is a more formidable procedure, it can be performed safely with excellent results.

The saline-cooled monopolar radiofrequency dissector (TissueLink) is a valuable adjunct for LPN. The device provided excellent hemostatic control with resection of as much as 40% of the renal parenchyma. Our initial observations of the device in the laboratory and in clinical use led us to develop a successful technique for its use for deep parenchymal resection, which is described in detail.

Our experience shows that standard open pediatric urological procedures may be performed safely and comfortably on an outpatient basis.

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