Endoscopic incision for the treatment of a ureteric valve

Abstract

weeks. Postoperative ultrasonography and IVU Case reportrevealed an almost normal left kidney. There was no recurrence of the left flank pain by the 36-month A 7-year-old boy presented with a history of dull pain in the left flank; IVU revealed a large hydronephrotic left follow-up. kidney with a filling defect in the upper ureter. There was no VUR and the diuretic renogram showed a left Comment ureteric obstruction and normal plasma flow in the left kidney. The preoperative diagnosis was left hydroneph-The congenital ureteric valve is relatively rare; only 30 cases have been reported to date (17 males and 13 rosis due to a ureteric polyp. A percutaneous endoscopic resection of the ureteric polyp was planned. Cystoscopy females, age range 10-94 years). Thirteen cases were associated with other congenital abnormalities [1][2][3]. revealed two normal ureteric orifices, and a retrograde pyelogram showed a filling defect of the upper ureter;The valve was on the left side in 16 cases, on the right in 13 and bilateral in one case. Eleven were located in the stenotic part of the ureter was tortuous (Fig. 1). A percutaneous nephrostomy dilated to 15 F was the upper ureter and the remainder in the lower ureter; 16 were annular, 13 were cusp-like and one was not placed through the upper calyx and the filling defect visualized using a multifunctional surgical endoscope described. Of 24 such patients who had undergone surgical treatment, nephrectomy or heminephrectomy (Universaltome, 13.5 F, Takai Co., Japan). The irregularities were not polyps but rather a ureteric valve of an was performed in nine, and 15 were treated with excision and end-to-end anastomosis. In the present case, the iris-like annular shape (Fig. 2). Using a hook-shaped cold knife, a 2 cm cut was made in the dorsal side of the ureteric stenosis was corrected by incision on the dorsal side of the ureter. Endoscopic incision is thought to be a valve until the yellowish peritoneal fat was visible. A 12 F indwelling endopyelotomy stent was used for useful treatment for the ureteric valve.

Holmium laser ablation: a successful treatment option for an obstructing ureteric valve

“…7 Other minimally invasive treatment options described include the removal of the valve with biopsy pens without resection 3 and the endoscopic incision with a hook-shaped cold knife on the dorsal side of the ureter. 8 Ureteric valve causing significant obstruction could also be surgically excised with primary ureteroureteral anastomosis or ureteropyelostomy. 9 Where renal function has been significantly compromised, a nephrectomy should be considered.…”

Hidronefrosis prenatal secundaria a válvulas ureterales

“…El tratamiento quirú rgico consiste en la escisió n quirú rgica del segmento que contiene la vá lvula y en la anastomosis té rmino-terminal. No obstante, el desarrollo de té cnicas mínimamente invasivas, como el tratamiento endoscó pico, llevando a cabo escisiones o ablaciones con lá ser de la vá lvula ureteral, han sido utilizados con buenos resultados 6,7 . En nuestro caso, el uso de estas té cnicas mínimamente invasivas, tal y como fue la dilatació n neumá tica, permitió resolver exitosamente la reestenosis postoperatoria, evitando de este modo una nueva intervenció n quirú rgica así como una mayor morbilidad asociada a una nueva intervenció n 8 .…”

“…En ausencia de hematoceles, hematoma intratesticular de gran tamañ o o rotura de la tú nica albugínea, el tratamiento mé dico consistente en el reposo, la administració n de fá rmacos antiinflamatorios y la suspensió n testicular está instaurado 6 . Las vá lvulas ureterales representan una causa rara de obstrucció n del tracto urinario superior.…”

Hidronefrosis prenatal secundaria a válvulas ureterales

“…El tratamiento quirú rgico consiste en la escisió n quirú rgica del segmento que contiene la vá lvula y en la anastomosis té rmino-terminal. No obstante, el desarrollo de té cnicas mínimamente invasivas, como el tratamiento endoscó pico, llevando a cabo escisiones o ablaciones con lá ser de la vá lvula ureteral, han sido utilizados con buenos resultados 6,7 . En nuestro caso, el uso de estas té cnicas mínimamente invasivas, tal y como fue la dilatació n neumá tica, permitió resolver exitosamente la reestenosis postoperatoria, evitando de este modo una nueva intervenció n quirú rgica así como una mayor morbilidad asociada a una nueva intervenció n Metrorragias como forma de presentació n de un carcinoma de cé lulas renales con metá stasis ová rica…”

“…Sin embargo, ante una clínica sospechosa o hallazgos ecográ ficos dudosos, la mayoría de los autores recomiendan la cirugía exploradora 5 . En ausencia de hematoceles, hematoma intratesticular de gran tamañ o o rotura de la tú nica albugínea, el tratamiento mé dico consistente en el reposo, la administració n de fá rmacos antiinflamatorios y la suspensió n testicular está instaurado 6 . .…”