Active surveillance for antenatally detected ureteroceles: Predictors of success

Andrioli, Veridiana; Guerra, Luis; Keays, Mélise; Keefe, Daniel T.; Tang, Kenneth; Sullivan, Katrina; Garland, Katie; Leonard, Michael P.

doi:10.1016/j.jpurol.2018.02.012

Cited by 16 publications

(10 citation statements)

References 18 publications

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“…Based on prior studies, abnormal scintigraphic scans are fairly prevalent in DCS patients [8,9]. In accordance with other studies [11,12], we demonstrated that patients with duplex system ureterocele exhibit a higher prevalence of rF-UTI compared to without. We revealed that 70% of ureterocele patients developed rF-UTI before any surgical procedures, which is slightly higher than in previous reports that show 50% rF-UTI incidence before surgery [13,14].…”

Section: Discussionsupporting

confidence: 91%

“…Ureteral dilatation was not signi cantly associated with rF-UTI among children with duplex systems in our study. However other reports that found rF-UTI rates to be 7-9 folds higher in patients with ureteral dilation than without, after correcting for VUR status [12,23]. Similarly, Lee et al also found that rF-UTI was more prevalent among patients with hydroureter than without [24].…”

Section: Discussionmentioning

confidence: 90%

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Risk factors for recurrent febrile urinary tract infection in patients with duplex collecting system

Wang,

Yang,

et al. 2024

Preprint

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Purpose Our goal was to establish the risk factors for recurrent febrile urinary tract infection (F-UTI) in children with duplex collecting system (DCS). Methods Patients seen for DCS from 2010 to 2020 were retrospectively followed. Those with using continuous low dose antibiotic prophylaxis (CAP) and incompletely duplicated systems were removed from the study. The primary endpoint of this study was recurrent F-UTI. We conducted univariate analysis of 5 risk factors, namely, gender, affected side (unilateral vs bilateral), hydronephrosis grade of the affected renal unit, ureteral dilatation (UD) grade, type of anatomy. Results We analyzed medical reports of 305 patients, of which 74.8% were female. Among the 305 patients, F-UTI developed in in81/119 (68.1%) patients with ureterocele, in 7/9 (77.8%) patients with VUR, in27/36 (75%) patients with both ureterocele and VUR, in8/12 (66.7%) patients with ectopic and VUR, and in 49/105 (46.7%) patients with ectopic. Univariate analysis found discernible difference in type of DCS, ureteral dilatation and grade of hydronephrosis between recurrent F-UTI and non F-UTI patients. Moreover, Cox proportional regression analysis revealed that type of DCS, grade of hydronephrosis were stand-alone risk factors for recurrent F-UTI. Conclusion High hydronephrosis grade and the presence of ureterocele, VUR were stand-alone risk factors for recurrent F-UTI in children with DCS.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 90%

Risk factors for recurrent febrile urinary tract infection in patients with duplex collecting system

Wang,

Yang,

et al. 2024

Preprint

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“…In this study, it was investigated whether age at first ED is an independent risk factor for the requirement of FST and early endoscopic treatment reduces risk for FST or not. While active surveillance has been discussed in recent literature (9) , our study revealed that early endoscopic treatment provides better result in terms of UTI and lower risk for FST. Satisfactory outcomes were reported in the literature with patients who underwent ED in young ages.…”

Section: Management Of Ureterocele Includes Endoscopic Ureterocele Tr...mentioning

confidence: 63%

“…The risk factors for further surgeries were discussed in the literature extensively. Ectopic ureterocele, VUR and DCS, prenatal vs postnatal presentation are the most analyzed risk factors for further surgeries (6,7,(9)(10)(11)(12)(13)(14)21) . On the other hand, active surveillance without intervention has been discussed in recent years.…”

Section: Management Of Ureterocele Includes Endoscopic Ureterocele Tr...mentioning

confidence: 99%

“…Nevertheless, endoscopic decompression (ED) is the most preferred method used in initial management (1,2) , which is sometimes supplemented with further surgical treatment (FST)(s) that required in 20% to 90% of cases reported in the literature (3)(4)(5)(6)(7)(8) . Multiple factors such as UTI, VUR, presentation period (prenatal or postnatal), collecting system anatomy (single or duplex), and localization of ureterocele (intravesical or ectopic) were analyzed in the literature to determine the factors that are associated with the risk of FST (6,7,(9)(10)(11)(12)(13)(14) . The aim of this study was evaluation of the relation between "age at first ED" and requirement of further surgical treatment.…”

Section: Introductionmentioning

confidence: 99%

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Üreterosel Tedavisinde İlk Endoskopik Dekompresyon Yaşının İkincil Cerrahi Gereksiniminde Bir Risk Faktörü Olarak Değerlendirilmesi

Akgül¹,

Tuğtepe²

2022

JTAPS

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Introduction:The aim of this study is to investigate whether age at endoscopic decompression (ED) is a risk factor for further surgical treatment (FST)(s) in the management of ureterocele. Materials and Methods:The data of 29 patients, who underwent surgery for ureterocele, were reviewed retrospectively. 18 of these patients, who had undergone only ED, were categorized under Group 1, the remaining 11 patients, who had undergone further surgical treatment(s) after ED, were categorized under Group 2. Results: Duplex collecting system (DCS) was detected in 33% and 100%, urinary tract infection (UTI) was detected in 33% and 72%, ectopic ureterocele (EU) was detected in 55% and 81%, and vesicoureteral reflux (VUR) was detected in 77% and 100%, of the patients in Group 1 and 2, respectively (p<0.05). The median age at ED was 3 (0-62) and 15 (0-83) months in groups, respectively (p=0.004). The capacity of age at ED in predicting the requirement for FST after ED was 77% by using ROC curve analysis. The analyses revealed that the cut off value of "age at ED" was 4 months. The risk for FST who underwent ED before 4 months was 7.6%, whereas 62.5 for patients older than 4 months at ED. Conclusions: While active surveillance was discussed in the literature about management of patients with ureterocele, the results of this study revealed that the age at endoscopic decompression is an important risk factor for further surgical treatment(s) and that early endoscopic treatment reduces the risk for further surgical treatment.

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Antenatal Hydronephrosis

Braga¹,

Herndon²

2023

Pediatric Surgery

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Active surveillance for antenatally detected ureteroceles: Predictors of success

Cited by 16 publications

References 18 publications

Risk factors for recurrent febrile urinary tract infection in patients with duplex collecting system

Risk factors for recurrent febrile urinary tract infection in patients with duplex collecting system

Üreterosel Tedavisinde İlk Endoskopik Dekompresyon Yaşının İkincil Cerrahi Gereksiniminde Bir Risk Faktörü Olarak Değerlendirilmesi

Antenatal Hydronephrosis

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