Examining trends in the treatment of ureterocele yields no definitive solution

Cohen, Seth A.; Juwono, Timothy; Palazzi, Kerrin; Kaplan, George W.; Chiang, George

doi:10.1016/j.jpurol.2014.09.001

Cited by 25 publications

(10 citation statements)

References 17 publications

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“…also confirmed in their study that the likelihood of requiring a second surgery was not increased after lower tract reconstruction. [ 13 ] Few authors have even considered upfront lower urinary tract reconstruction in all patients with ureterocele associated with duplex moiety irrespective of reflux in the lower moiety or the function of the upper moiety. [ 14 ] The authors, in their study, promoted this approach because it treats the primary pathology and preserves renal function in the long-term.…”

Section: Discussionmentioning

confidence: 99%

Management and outcomes of ureteroceles in children

Jain

Agarwala

Dhua

et al. 2021

Indian Journal of Urology

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Introduction: Ureterocele is a rare urogenital malformation. The treatment is variable and complicated as it depends on several factors. The aim of this study was to evaluate the management and outcomes of children with ureterocele and to compare single system and duplex system ureteroceles. Materials and Methods: A retrospective study was conducted and all patients with ureterocele operated from January 1992 to December 2018 were included. The records of those included were assessed, and a detailed case record sheet was filled. The outcome parameters assessed were the persistence of symptoms and additional surgical procedure performed. Results: Forty-seven patients (28 boys and 19 girls) with a median age of presentation of 21 months were included. Four patients had bilateral ureterocele. Overall, 51 renal units with ureterocele were studied. Twenty renal units of the 31 renal units with duplex system underwent cystoscopic decompression, and of these, 8 (40%) needed a second procedure. Fourteen renal units of the remaining 20 renal units with single system underwent cystoscopy and decompression, and of these, 1 (7%) required another procedure (P = 0.024). Sixteen renal units had ectopic ureterocele, of which 9 (56%) underwent heminephrectomy/nephrectomy. Intravesical ureterocele was present in 35 renal units, of which only 2 (5.7%) underwent nephrectomy or heminephrectomy ( P < 0.001). Conclusion: Duplex system ureteroceles are more likely to require a second procedure following an endoscopic puncture. Units with ectopic ureterocele were more likely to need nephrectomy.

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Section: Discussionmentioning

confidence: 99%

Management and outcomes of ureteroceles in children

Jain

Agarwala

Dhua

et al. 2021

Indian Journal of Urology

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“…ureteroneocystostomy, combined technique with upper and lower pole reconstruction, endoscopic vesicoureteral reflux correction (6,18) . ED is usually the initial treatment for most of the patients (1-8, 11,17,19,20) .…”

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

confidence: 99%

“…However, FST are required in 20-90% of these patients in the literature (4)(5)(6)(7)(8) . Some patients need even a third or fourth intervention (5,18) . The major challenge is determining how to prevent further surgical requirements after ED.…”

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

confidence: 99%

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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“…A ureterocele is a relatively common congenital anomaly and represents cystic dilatation of the ureter at the insertion to the urinary bladder. The diagnosis is usually made by identifying the ureteric insertion on fluoroscopic or crosssectional studies, and it is estimated that around 75% of patients with ureteroceles have a duplicated collecting system (5). Most patients with this condition present during infancy with recurrent urinary tract infections and are rarely asymptomatic until adulthood (6).…”

Section: Imaging Findingsmentioning

confidence: 99%

“…In children, these symptoms include vesicoureteric or bladder outlet obstruction with prolapse. Additionally, current screening with prenatal US for congenital anomalies usually enables identification of this type of lesion much earlier (5,6). On US images, a cystic structure may be visible in the vicinity of the vesicoureteric junction, with associated reflux of obstruction.…”

Section: Imaging Findingsmentioning

confidence: 99%