Impact of Prenatal Diagnosis on the Morbidity Associated With Ureterocele Management

Upadhyay, Jyoti; Bolduc, Stéphane; Braga, Luis H.; Farhat, Walid A.; B??GLI, DARIUS J.; McLorie, Gordon A.; Khoury, Antoine E.; El-Ghoneimi, Alaa

doi:10.1097/00005392-200206000-00058

Cited by 14 publications

(19 citation statements)

References 29 publications

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“…1 The current trend is more and more towards minimally invasive endoscopic incision. It is highly successful in patients with single-system ureterocele [2][3][4][5] ; however, its effec-tiveness in duplex-system ureterocele is controversial. [6][7][8] There are both proponents and opponents of upper-pole nephroureterectomy alone, citing various reasons for or against the procedure.…”

Section: What This Paper Addsmentioning

confidence: 99%

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Management of duplex‐system ureterocele

Mariyappa

Barker

Samnakay

et al. 2013

J Paediatrics Child Health

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Section: What This Paper Addsmentioning

confidence: 99%

“…1 The best treatment modality is controversial. 2 The retained non-functioning moiety does not have malignant potential. 3 Treatment is aimed at preventing urinary tract infection and preserving renal function.…”

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confidence: 99%

Management of duplex‐system ureterocele

Mariyappa

Barker

Samnakay

et al. 2013

J Paediatrics Child Health

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“…Dipstick tests have the advantage of being quick and easy to perform and can be carried out in primary care giving an immediate result. Microscopic examination of urine samples for leukocytes or bacteria [4] is considerably more time consuming and labour intensive than the dipstick method[5]. However, unlike culture, it can be used to give results within the primary care setting.…”

Section: Introductionmentioning

confidence: 99%

Rapid tests and urine sampling techniques for the diagnosis of urinary tract infection (UTI) in children under five years: a systematic review

et al. 2005

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BackgroundUrinary tract infection (UTI) is one of the most common sources of infection in children under five. Prompt diagnosis and treatment is important to reduce the risk of renal scarring. Rapid, cost-effective, methods of UTI diagnosis are required as an alternative to culture.MethodsWe conducted a systematic review to determine the diagnostic accuracy of rapid tests for detecting UTI in children under five years of age.ResultsThe evidence supports the use of dipstick positive for both leukocyte esterase and nitrite (pooled LR+ = 28.2, 95% CI: 17.3, 46.0) or microscopy positive for both pyuria and bacteriuria (pooled LR+ = 37.0, 95% CI: 11.0, 125.9) to rule in UTI. Similarly dipstick negative for both LE and nitrite (Pooled LR- = 0.20, 95% CI: 0.16, 0.26) or microscopy negative for both pyuria and bacteriuria (Pooled LR- = 0.11, 95% CI: 0.05, 0.23) can be used to rule out UTI. A test for glucose showed promise in potty-trained children. However, all studies were over 30 years old. Further evaluation of this test may be useful.ConclusionDipstick negative for both LE and nitrite or microscopic analysis negative for both pyuria and bacteriuria of a clean voided urine, bag, or nappy/pad specimen may reasonably be used to rule out UTI. These patients can then reasonably be excluded from further investigation, without the need for confirmatory culture. Similarly, combinations of positive tests could be used to rule in UTI, and trigger further investigation.

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“…When the condition is diagnosed prenatally, the majority of cases can be managed conservatively. However, if the ureterocele obstructs bladder outflow this can result in severe obstructive uropathy and chronic renal failure. Fetal intervention should be considered in the presence of sonographic findings suggestive of progressive obstruction, such as increasing bilateral hydronephrosis, hyperechogenic kidneys and significant reduction in amniotic fluid volume.…”

Section: Discussionmentioning

confidence: 99%

New minimally invasive technique for cystoscopic laser treatment of fetal ureterocele

Persico

Berrettini

Fabietti

et al. 2017

Ultrasound in Obstet & Gyne

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Prenatal ultrasound detection of fetal ureterocele with bilateral hydroureteronephrosis, obstruction of the bladder outlet and progressive amniotic fluid reduction have been associated with a significant risk of end-stage chronic renal disease after birth. Fetal cystoscopic laser incision of the ureterocele, using standard 3.5-mm fetoscopic access to the amniotic cavity and the fetal bladder with the aim of relieving the bladder outflow obstruction to preserve renal function, has been reported previously in a case with a favorable outcome. We report on two additional cases of fetal ureterocele treated by cystoscopic laser decompression. In the first case, a standard 3.3-mm uterine entry was used. In the second case, a new approach was adopted using an 'all-seeing needle' 1.6-mm endoscope. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

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Impact of Prenatal Diagnosis on the Morbidity Associated With Ureterocele Management

Cited by 14 publications

References 29 publications

Management of duplex‐system ureterocele

Management of duplex‐system ureterocele

Rapid tests and urine sampling techniques for the diagnosis of urinary tract infection (UTI) in children under five years: a systematic review

New minimally invasive technique for cystoscopic laser treatment of fetal ureterocele

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