Minimally invasive techniques for management of the ureterocele and ectopic ureter: upper tract versus lower tract...

Area of Science:

• Pediatric Urology
• Surgical Management
• Congenital Anomalies

Background:

• Ureterocele and complete pyeloureteral duplication in children, particularly with high-grade vesicoureteral reflux, present complex management challenges.
• Surgical trends are shifting from open reconstruction to conservative and minimally invasive techniques.

Purpose of the Study:

• To review and compare lower and upper tract surgical approaches for ureterocele with complete pyeloureteral duplication.
• To evaluate operative techniques, patient selection, outcomes, and follow-up for these approaches.

Main Methods:

• Review of lower tract approaches: endoscopic ureterocele incision and ipsilateral ureteroureterostomy.
• Review of upper tract approaches: ureterocele moiety heminephrectomy.
• Analysis of published data on outcomes, patient selection, and postoperative care.

Main Results:

• Current evidence supports endoscopic puncture as a safe and effective treatment for symptomatic children with single-system intravesical ureteroceles.
• Data on other approaches (ureteroureterostomy, heminephrectomy) are also discussed in terms of their respective indications and outcomes.

Conclusions:

• Endoscopic puncture is a viable first-line treatment for select pediatric ureterocele cases.
• Further research is needed to clarify optimal management strategies for complex presentations, including those with high-grade reflux.