Üreterosel Tedavisinde İlk Endoskopik Dekompresyon Yaşının İkincil Cerrahi Gereksiniminde Bir Risk Faktörü Olarak Değerlendirilmesi

Abstract

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.