Ureteroceles in infancy and childhood: in search of the correct surgical approach

Frey, Peter; Cohen, S. J.

doi:10.1007/bf00181981

Cited by 4 publications

(2 citation statements)

References 16 publications

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“…lVP has usually been the only functional renal imaging examination especially in infants. If lhe I\'P did not visualize the affected pole or showed faint opacification the common operative procedure has been heminephrectomy (1, 3,11,13). Preservation of the upper pole segment obstructed by a ureterocele has in fact been regarded as almost never justified because of poor overall renal funclion (8) i. e. when this upper segment represents only 113 to 1/6 of the kidney parenchyma.…”

Section: Discussionmentioning

confidence: 99%

DMSA Scintigraphy in Renal Duplex System

Cm¹,

Wallin²

1993

Eur J Pediatr Surg

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During a 4-year period 40 children (13 boys and 27 girls) with renal duplex system were examined with DMSA scintigraphy. The age at the investigation varied from 18 days to 9 years, mean 2.5 years. Duplicated system existed in 52 kidneys, bilaterally in 12 cases, right-sided in 10 and left-sided in 18 cases. The renal DMSA scintigraphy of the 52 duplicated kidneys revealed insignificant parenchymal damage in 19 kidneys. Moderate parenchymal damage existed in 10 kidneys. In the remaining 23 kidneys, severely deteriorated function of the upper moiety was found in 15 cases and of the lower pole in 9 cases, as both moieties were affected in one kidney. The function of the severely deteriorated moiety varied between 0% and 14%, mean 5.7% of the total renal function. All the 23 cases with severely deteriorated function were operated upon, 22 with heminephrectomy and one with nephrectomy. The assessment of parenchymal function of the separate parts of the kidney with duplex system by DMSA scintigraphy is of great value in the decision of management and surgical procedure.

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Section: Discussionmentioning

confidence: 99%

DMSA Scintigraphy in Renal Duplex System

Cm¹,

Wallin²

1993

Eur J Pediatr Surg

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“…These results are mark edly less favorable in ectopic ureterocele, as has been noticed by our group and as Blyth et al [12] also found. Even a preexisting reflux in the ipsilateral lower-pole ure ter can disappear following endoscopic treatment [4], EIU may serve as emergency treatment for severe infection with pyonephrosis, instead of ureterostomy and percutaneous nephrostomy [14], particularly in the neo nate for whom the true renal function is difficult to mea sure. In these children with sepsis, rapid endoscopic treat ment allows for minimal anesthesia, the least possible manipulation of the infected urinary system, and efficient antibiotic action [4], When severe urinary obstruction is present, the value of renal function may be doubtful despite IVU and scinti graphy.…”

Section: Resultsmentioning

confidence: 99%

Endoscopic Management of Ureteroceles in Children

Jelloul

Berger

Frey³

1997

Eur Urol

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Ureteroceles in children: an ongoing challenge

1997

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The treatment of ureteroceles in children requires an individualised approach. Antenatal diagnosis is the ideal, so that postnatal urinary antibiotic prophylaxis and appropriate investigations can be organised. Postnatal investigations should assess both upper and lower urinary tract. Renal and bladder ultrasound and radiographic micturating cystourethragraphy under antibiotic cover will both detect vesicoureteric reflux and assess any bladder outlet obstruction due to the ureterocele. Renal function, particularly of the upper moiety, is best evaluated by technetium Tc99m dimercaptosuccinic acid renal scan. Both function and obstruction can be quantitated by the Tc99m-mercaptoacetyltriglycine isotope scan with intravenous volume expansion (10 ml/kg) and furosemide diuresis (1 mg/kg). Intravenous urography provides the best anatomic information when the upper moiety is functional. The surgical management is based on the clinical situation, which is often variable, and therefore needs to be tailored for each patient. The general principles include restoration of anatomy to as near normal as possible and preservation of functional renal tissue.

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Ureteroceles in infancy and childhood: in search of the correct surgical approach

Cited by 4 publications

References 16 publications

DMSA Scintigraphy in Renal Duplex System

DMSA Scintigraphy in Renal Duplex System

Endoscopic Management of Ureteroceles in Children

Ureteroceles in children: an ongoing challenge

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