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Endoscopic treatment of vesicoureteral reflux associated with ureterocele

Boris Chertin1, Nochiparambil Mohanan, Amicur Farkas

  • 1Department of Urology, Shaare Zedek Medical Centre, Jerusalem. bchertin@yahoo.com

The Journal of Urology
|August 21, 2007
PubMed

Insights

Endoscopic treatment for vesicoureteral reflux (VUR) in children with ureterocele is effective and safe. This minimally invasive approach resolves VUR in most cases, often avoiding open surgery.

Area of Science:

  • Pediatric Urology
  • Minimally Invasive Surgery
  • Urologic Oncology

Background:

  • Ureteroceles are congenital abnormalities that can lead to complications such as vesicoureteral reflux (VUR).
  • VUR, the abnormal backward flow of urine from the bladder to the kidneys, increases the risk of urinary tract infections and renal damage.
  • Endoscopic management offers a less invasive alternative to open surgery for VUR associated with ureteroceles.

Purpose of the Study:

  • To evaluate the efficacy and safety of endoscopic treatment for VUR in children with ureteroceles.
  • To determine the long-term outcomes of this minimally invasive approach.
  • To assess the rate of spontaneous resolution and need for further intervention.

Main Methods:

  • A retrospective review of 109 children (median age 6 months) who underwent endoscopic ureterocele puncture between 1984 and 2005.
  • Ureterocele puncture was performed using a 3Fr Bugbee electrode.
  • Indications for surgical correction included high-grade VUR or breakthrough infections; median follow-up was 10 years.

Main Results:

  • Spontaneous VUR resolution occurred in 42% of refluxing units after ureterocele puncture.
  • Endoscopic correction successfully treated VUR in 70% after one injection and 91% after two injections.
  • Overall, 13% of patients experienced VUR to the ureterocele moiety post-puncture, with most managed successfully via endoscopic correction or conservative measures.

Conclusions:

  • Endoscopic treatment for VUR associated with ureterocele is a simple, safe, and effective long-term solution.
  • This approach successfully avoids open surgery in the majority of pediatric patients.
  • Endoscopic ureterocele puncture is a valuable primary treatment option.
Abstract

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