Efficacy and Safety of Transurethral Photoselective Greenlight^™ Laser Vaporization for the Treatment of Orthotopic Ureteroceles in Adults

Abstract

Transurethral photoselective Greenlight laser vaporization is safe, effective, and efficient for the management of orthotopic urecteroceles in adults. Therefore, this technique should be considered as the initial treatment in most patients.

Endoscopic meatotomy in the treatment of ureterocele: results in adult patients

“…Ureterocele is a cystic dilatation of the sub-mucosal segment of the intravesical ureter, and its etiology remains uncertain [ 1 , 3 ]. This is an entity commonly observed in newborns and children, most often accompanied by ureteric duplicity and ectopic abortion of the ureteral meatus in the urethra [ 3 ]. Adult ureteroceles rarely occur on duplicity and are exceptionally extra vesical [ 4 ].…”

“…In our series, 75% of the ureteroceles were classified as intravesical on a single ureter (type A according to the Bruézière classification). This high frequency of simple forms explains the good tolerance and often moderate repercussions of adult ureteroceles [ 3 ]. Treatment, indicated in complicated or symptomatic cases, is not univocal [ 4 ].…”

“…Treatment, indicated in complicated or symptomatic cases, is not univocal [ 4 ]. The treatment aims to prevent urinary tract infections, preserve renal function, ensure good ureterovesical drainage, prevent vesicoureteral reflux, to minimize surgical complications with a minimum number of procedures and to retain the possibility of further reconstruction [ 3 - 5 ]. The evolution of endo-urological techniques and the better understanding of the anti-reflux mechanisms of the ureter has resulted in a renewed interest in endoscopic meatotomy, which is increasingly being practiced.…”

“…Liu et al . treated ureteroceles in 40 adults by selective laser vaporization of the greenlight type and concluded that this technique is safe and effective for the treatment of orthotopic ureterocele in adults [ 3 ]. The comparison between different endoscopic techniques is difficult because there is no prospective, randomized, controlled study.…”

Adult Bilateral Ureteroceles Presenting with Lower Urinary Tract Symptoms and Acute Urinary Retention

“…Treatment options vary but most reported cases seem to favor a low transverse incision with Collin's knife in a “smiling” fashion, similarly to what is being advocated for the pediatric population ( Table 1 ) [ 11 ]. Recently, Holium and KTP lasers have been used to make the incision [ 12 , 13 ]. Other approaches such as simple puncture or endoscopic unroofing with the resectoscope have also been described ( Table 1 ).…”