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Long-term bladder function after ureterocele decompression in children.

Annabel Paye-Jaouen1, Filippo Pistolesi1, Nathalie Botto1

  • 1Department of Pediatric Surgery and Urology, Robert-Debré University Hospital, Assistance-Publique Hôpitaux de Paris, Université Paris Diderot, Sorbonne Paris Cité, Paris, France.

The Journal of Urology
|March 31, 2015
PubMed
Summary
This summary is machine-generated.

Ureterocele decompression in childhood rarely causes long-term bladder dysfunction. Even with subsequent bladder surgery, significant issues are uncommon, ensuring good bladder function outcomes.

Keywords:
congenital abnormalitieslower urinary tract symptomsureteroceleurinary bladderurinary tract infections

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Area of Science:

  • Pediatric Urology
  • Urologic Oncology

Background:

  • Duplex system ureteroceles are congenital anomalies requiring surgical intervention.
  • Long-term bladder function following ureterocele surgery in children is not well-established.

Purpose of the Study:

  • To assess long-term bladder function in children treated for duplex system ureteroceles.
  • To compare functional outcomes based on surgical approach: ureterocele decompression versus bladder surgery.

Main Methods:

  • A cohort of toilet-trained children treated for ureteroceles between 1990 and 2010 were evaluated.
  • Voiding dysfunction was assessed using the Dysfunctional Voiding Symptom Score (DVSS) questionnaire and noninvasive studies (uroflowmetry, electromyography, post-void residual urine).
  • Patients were categorized into Group 1 (ureterocele decompression) and Group 2 (primary/secondary bladder surgery).

Main Results:

  • Forty-five patients with a mean follow-up of 9.5 years were analyzed.
  • Group 1 (n=33) showed a mean DVSS of 1.5, with 22% exhibiting abnormal uroflowmetry or post-void residual urine.
  • Group 2 (n=12) had a mean DVSS of 4, with 66% showing abnormal uroflowmetry or post-void residual urine (p=0.036). Only one child required intermittent catheterization.

Conclusions:

  • Ureterocele decompression in early childhood is associated with favorable long-term bladder function.
  • Secondary bladder surgery, when necessary, rarely results in significant long-term bladder dysfunction.
  • Surgical management of duplex system ureteroceles generally preserves bladder function effectively.