Endoscopic Management of
Ureteroceles in Children

Jelloul, L.; Berger, David L.; Frey, Peter

doi:10.1159/000480833

Cited by 30 publications

(7 citation statements)

References 13 publications

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“…11,12 It is highly successful in treating patients with single-system ureterocele [2][3][4][5] ; however, there are several articles in the literature reporting that patients initially treated with the endoscopic approach often require additional surgical procedures to treat VUR, to excise the ureterocele or to remove the non-functioning upper moiety. [4][5][6][7]13,14 The need for a second surgery after endoscopic incision can range from 48% to 100%. 1 Proponents of endoscopic surgery argue the following: 1 It is an alternative to complex vesical surgery in the neonatal period, reducing the risk of urinary incontinence due to bladder neck or sphincter injury 15 2 Neonatal ureterocele decompression facilitates subsequent lower urinary tract reconstruction in the infant bladder.…”

Section: Discussionmentioning

confidence: 99%

Management of duplex‐system ureterocele

Mariyappa

Barker

Samnakay

et al. 2013

J Paediatrics Child Health

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Section: Discussionmentioning

confidence: 99%

Management of duplex‐system ureterocele

Mariyappa

Barker

Samnakay

et al. 2013

J Paediatrics Child Health

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“…Creating a small opening seems to be another crucial factor to prevent reflux, but it also increases the risk of unsatisfactory ureteric decompression. The Bugbee electrode, ureteric catheter stylet wire, Collin knife and laser, either puncturing or incising the ureterocele, have all been used [2,9,11,18,22]. We adopted the straightened loop of the resectoscope to create a 2–4 mm wide low opening in the ureterocele.…”

Section: Discussionmentioning

confidence: 99%

“…However, controversies remain about its effectiveness in duplex‐system ureteroceles (DSU) and especially when the ureterocele is ectopic [6–8]. Recent series reported that in this case patients initially treated with an endoscopic approach often required additional surgical procedures because of persistent VUR either in the lower pole or contralateral kidneys, de novo VUR in the punctured ureterocele moiety and/or a nonfunctioning upper pole [6,7,9–12]. Moreover, opponents of TUI maintain that in a DSU the upper moiety function is often negligible and the potential for recovery poor, the parenchyma being almost always dysplastic [13–16].…”

Section: Introductionmentioning

confidence: 99%

Transurethral incision of duplex system ureteroceles in neonates: does it increase the need for secondary surgery in intravesical and ectopic cases?

et al. 2004

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OBJECTIVE To evaluate the relevance of ureterocele ectopia and associated reflux on the outcome of duplex system ureteroceles (DSU) after neonatal transurethral incision (TUI). PATIENTS AND METHODS The study included 41 neonates with a diagnosis of DSU; the ureterocele was ectopic in 24 (58%). Before TUI, vesico-ureteric reflux (VUR) was present in 13 lower moieties (32%) and seven contralateral ureters (17%). TUI was always performed within the first month of life. The follow-up and management were tailored for each patient from the findings at ultrasonography, voiding cysto-urethrography and renal scintigraphy. Results of intravesical and ectopic DSU were compared using Fisher''s exact test. RESULTS TUI was effective in allowing ureteric decompression in all but one patient (2.4%). After TUI, VUR ceased in six lower ipsilateral moieties and in two contralateral ureters, while new VUR occurred in three contralateral kidneys. De novo VUR in the punctured moiety appeared in 13 cases (32%). Nine upper poles were not functioning. Twenty-one patients (51%) required secondary surgery. Ureteric reimplantation was indicated exclusively for reflux in the punctured moiety in only in two cases (5%), while in a further two iatrogenic reflux in a nonfunctioning upper moiety required total heminephro-ureterectomy. There was no significant difference between intravesical and ectopic ureteroceles in the occurrence of VUR in the punctured moiety, rate of nonfunctioning upper poles or need for secondary surgery. CONCLUSIONS About half of the patients with a DSU need secondary surgery, but this is rarely indicated for de novo reflux in the punctured moiety only. The need for secondary surgery was greater whenever there was associated reflux before endoscopic incision. There was no difference in the outcome of intravesical and ectopic ureteroceles and such distinction seems no longer to be of clinical relevanc

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“…In children this technique is also gaining acceptance with EIU being considered a definitive procedure for intravesical ureteroceles in 71.5%. However, almost all ectopic ureteroceles require secondary surgical treatment [10]. Coplen and Duckett showed that the low transverse incision of intravesical ureteroceles in children was a definitive procedure in more than 90% of cases [2].…”

Section: Discussionmentioning

confidence: 99%