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Clinical evolution of vesicoureteral reflux following endoscopic puncture in children with duplex system ureteroceles

Lisieux E Jesus1, Walid A Farhat, Antonio C M Amarante

  • 1Division of Urology, Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada.

The Journal of Urology
|August 25, 2011
PubMed

Insights

Vesicoureteral reflux can occur after ureterocele puncture in pediatric duplex systems but often resolves spontaneously. Close surveillance is recommended initially for managing this condition.

Area of Science:

  • Pediatric Urology
  • Endourology
  • Congenital Abnormalities

Background:

  • Pediatric duplex systems are prone to ureteroceles, which can cause complications.
  • Vesicoureteral reflux (VUR) is a common comorbidity associated with ureteroceles.
  • Endoscopic puncture is a minimally invasive approach for ureterocele treatment.

Purpose of the Study:

  • To investigate the clinical course of VUR following endoscopic ureterocele puncture in pediatric duplex systems.
  • To determine the incidence and characteristics of VUR post-procedure.
  • To evaluate the natural history and management outcomes of VUR after this intervention.

Main Methods:

  • Retrospective chart review of pediatric patients treated for duplex system ureteroceles between 1992 and 2007.
  • Analysis of patient demographics, diagnostic findings, and pre- and post-operative VUR status.
  • Specific focus on the resolution or persistence of VUR after endoscopic puncture.

Main Results:

  • 60 patients analyzed; 67% had pre-puncture VUR.
  • New-onset VUR occurred in 40% post-procedure, often ipsilateral or contralateral.
  • Spontaneous VUR resolution or improvement was observed in 72% of cases.
  • 42% required further surgical intervention for VUR.

Conclusions:

  • VUR post-ureterocele puncture can arise independently of the procedure itself.
  • A significant proportion of VUR cases demonstrate spontaneous resolution, supporting initial conservative management.
  • Endoscopic puncture of ureterocele is a viable and attractive initial treatment option for pediatric duplex systems due to its simplicity and potential for VUR resolution.
Abstract

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