Serious Complication after Laser Treatment of Ureterocele in an Infant

Abstract

Endoscopic decompression has been recently suggested as the first line treatment of ureterocele in children, including laser transurethral incision. We report a case of a unique but very serious complication after simple ureterocele puncture using a holmium laser in an infant. A 6-week-old male with a history of laser treatment of right simple ureterocele (procedure performed at the other institution 2 days earlier) was admitted because of sepsis. Imaging studies revealed urine leak around the bladder. Destroyed right bladder wall with perforation (locally coagulated and buried tissue) and damaged distal part of the right ureter along the distance of 3-4 cm were found during cystoscopy and laparotomy. Bladder was closed wall after removal of damaged tissues and then end right ureterocutaneostomy was done. The presented case shows that one has to be very careful using new techniques for endoscopic treatment, especially in very young patients and complications may overweight the advantages. KeywordsUreterocele, Laser therapy, Endoscopic incision, Children Case ReportA 6-week-old male after laser incision of a simple right ureterocele performed at the other hospital two days before admission to our institution, was admitted because of general bad condition and signs and symptoms of sepsis. Endoscopic incision was done as an outpatient procedure and a boy was discharged home immediately after cystoscopy.Ultrasound (US) showed mild distention of the right collecting system and upper part of the right ureter CASE REPORT