Evolution of Endoscopic Management of Ectopic Ureterocele: A New Approach

Abstract

This new endoscopic approach is highly effective in the treatment of children with ectopic ureteroceles.

Management of duplex system ureteroceles in neonates and infants

“…1,6 several instruments can be used for the pro cedure: bugbee electrodes, cold knives, metal catheter guides, and lasers. 43 Kajbafzadeh et al 43 described a modified approach involving fulguration of the inter nal layers of the ureterocele to promote adhesion of these layers after collapse. this approach completely prevented the development of de novo vur while achieving a decompression rate of 82%.…”

“…this approach completely prevented the development of de novo vur while achieving a decompression rate of 82%. the choice of endoscopic technique, however, seems to be impor tant only for the balance between efficient decompres sion and avoidance of de novo reflux in the punctured moiety; 43,45,46 in general, the larger the incision, the more effective the decompression, but the higher the risk of de novo vur. as discussed before, instead, the choice of decompression technique has little bearing on the treatment of associated vur and for upper pole func tion improvement.…”

“…38,47 in one series, only 1 case out of 49 patients presenting with refluxing units treated by initial endoscopic puncture and subse quent endoscopic treatment of vur required ureteric implantation. 48 Kajbafzadeh et al 43 even proposed a pre emptive endoscopic treatment of all ureters that showed signs of reflux on the micturating cysto urethrography performed before endoscopic decompression, and reported a secondary surgery rate of 10% after 4.2 years' followup.…”

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

“…All endoscopic approaches aim to improve subsequent surgical success, but an optimal endoscopic technique for ureteroceles has not been established because of insufficient prospective randomized controlled trials and difficulty in comparison with different approaches. 7 In adults, ureteroceles are amenable to endoscopic management. Ureterocele unroofing is also no longer recommended.…”

Pediatrik Endoskopik Üroloji’de Son Durum

“…Endoüroloji; vezikoüreteral reflü, posterior üretral valv, şok dalga litotripsinin başarısız ya da uygun olmadığı üreter ve böbrek taşlarının tedavisinde etkin ve güvenilir bir yöntem olarak kabul edilmektedir. Laparoskopik ve robotik cerrahideki ilerlemeler, pediatrik yaş grubunda da; bu tekniklerin açık cerrahideki çeşitliliği sağlayacak şekilde uygulanabileceğini ortaya koymuştur (1)(2)(3). Bu derlemede, pediatrik endoskopik üroloji alanındaki gelişmelerin güncel literatür eşliğinde gözden geçirilmesi amaçlanmıştır.…”