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Related Experiment Videos

Obstructive ureterocele-an ongoing challenge.

E Merlini1, P Lelli Chiesa

  • 1Department of Paediatric Surgery, Maggiore della Carità Hospital, Corso Mazzini 18, Novara, Italy. merlini1@libero.it

World Journal of Urology
|June 19, 2004
PubMed
Summary

Ureteroceles, cystic ureteral dilations, often found in children, require prompt diagnosis and treatment. Management strategies vary based on ureterocele type and associated vesicoureteral reflux (VUR), with endoscopic or surgical interventions tailored to patient outcomes.

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Area of Science:

  • Pediatric Urology
  • Congenital Anomalies
  • Urinary Tract Malformations

Background:

  • Ureterocele is a congenital cystic dilatation of the distal ureter, commonly associated with ureteral duplication.
  • It is frequently diagnosed prenatally or in early childhood, often presenting with urinary tract infections or obstruction.
  • Accurate diagnosis involves ultrasound, voiding cystourethrography for vesicoureteral reflux (VUR), and renal scintigraphy for function assessment.

Purpose of the Study:

  • To review the diagnostic modalities for ureteroceles.
  • To outline current treatment strategies for intravesical and ectopic ureteroceles.
  • To discuss the outcomes and reoperation rates associated with different management approaches.

Main Methods:

  • Review of existing literature on ureterocele diagnosis and management.

Related Experiment Videos

  • Analysis of treatment outcomes based on ureterocele type (intravesical vs. ectopic) and presence of VUR.
  • Comparison of endoscopic and surgical intervention success rates.

    • Main Results:

    • Vesicoureteral reflux (VUR) is common, affecting the lower pole in 50% of cases or the contralateral kidney in 25%.
    • Endoscopic puncture is effective for emergency treatment or uncomplicated intravesical ureteroceles, with 7-23% requiring further surgery.
    • Ectopic ureteroceles, especially with VUR, have higher reoperation rates (48-100% for endoscopic, 15-100% for surgical), often necessitating secondary bladder procedures.

    Conclusions:

    • Endoscopic incision is suitable for emergency or intravesical ureteroceles.
    • Upper pole partial nephrectomy is preferred for ectopic ureteroceles without VUR.
    • Ectopic ureteroceles with VUR require anticipated secondary bladder surgery for optimal management.