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Updated: Jun 5, 2026
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Effectiveness of primary endoscopic incision in treatment of ectopic ureterocele associated with duplex system
Ottavio Adorisio1, Antonio Elia, Luca Landi
1Pediatric Urology Unit, Anna Meyer Children’s Hospital, Florence, Italy. o.adorisio@yahoo.it
Insights
Endoscopic incision for ectopic ureterocele in children is a safe and effective treatment. This minimally invasive approach offers long-term success, avoiding extensive surgery in most cases.
Area of Science:
- Pediatric Urology
- Minimally Invasive Surgery
- Urological Endoscopy
Background:
- Ectopic ureterocele is a congenital anomaly often requiring intervention.
- Endoscopic treatment is frequently the preferred initial approach for ureterocele management.
Purpose of the Study:
- To evaluate the long-term effectiveness and safety of endoscopic treatment for ectopic ureterocele in children.
- To assess the outcomes of primary endoscopic incision in managing ureterocele.
Main Methods:
- A cohort of 46 children with ectopic ureterocele underwent primary endoscopic incision.
- Follow-up included clinical assessment, ultrasound, renography, and voiding cystourethrography.
- Low-dose antibiotic prophylaxis was administered until reflux resolution was confirmed.
Main Results:
- Successful ureterocele decompression was achieved in 93% of patients.
- Vesicoureteral reflux occurred in 30% of cases, with most resolving spontaneously or with endoscopic correction.
- No deterioration in renal function was observed post-procedure.
Conclusions:
- Primary endoscopic puncture of ureterocele is a simple, safe, and effective long-term solution.
- This technique successfully avoids complete reconstruction in the majority of pediatric patients.
- Endoscopic management offers a favorable alternative for ectopic ureterocele treatment.
Objectives:
To report our experience with the endoscopic treatment of ectopic ureterocele to demonstrate its long-term effectiveness. Endoscopic treatment is often recommended as the initial and definitive treatment in patients with ureterocele.
Methods:
A total of 46 children with ectopic ureterocele in a duplex system underwent primary endoscopic incision from January 1998 to January 2006. The mean follow-up was 3.8 years. Of the 46 children, 35 had been diagnosed prenatally and 11 had been diagnosed after birth because of a urinary tract infection. Low-dose antibiotic prophylaxis was administered to all children and was maintained until voiding cystourethrography showed no reflux. The pre- and postoperative evaluation included clinical assessment, ultrasound evaluation, diethylenetriaminepentacetic acid renography, and cyclic voiding cystourethrography.
Results:
Ureterocele decompression was achieved in 43 patients (93%). Three patients required additional surgery for persistent ureterocele (1 underwent ureteroureterostomy and 2 ureteropyelostomy). None of our patients showed deterioration of renal function after the procedures. Vesicoureteral reflux was seen in the lower moiety of the ipsilateral kidney in 14 patients (30%). Of the 14 patients with vesicoureteral reflux, 10 had spontaneous resolution. The remaining 4 underwent endoscopic correction. Five patients (10%) developed de novo vesicoureteral reflux in the ipsilateral ureterocele moiety. Of these 5 patients, 3 were treated with endoscopic injection and 2 had spontaneous resolution after 6 months of follow-up.
Conclusions:
Our data have shown that primary endoscopic puncture of a ureterocele is a simple, long-term, effective, and safe procedure, avoiding complete reconstruction in most patients.
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