[Endoscopic incision of intravesical ureteroceles in patients with duplex system]
Insights
Cystoscopic drainage of intravesical ureterocele in duplex systems significantly reduces urinary tract infections and urinary dilation, improving patient clinical status and renal function.
Area of Science:
- Pediatric Urology
- Surgical Innovation
- Renal Function Assessment
Background:
- Duplex systems with intravesical ureterocele can cause recurrent UTIs and urinary obstruction.
- Early intervention is crucial for preserving renal function in affected children.
Purpose of the Study:
- To assess the clinical outcomes and renal function in patients with duplex systems and intravesical ureterocele post-cystoscopic drainage.
- To evaluate the efficacy of cystoscopic puncture in managing these complex pediatric uropathies.
Main Methods:
- Nine pediatric patients with duplex systems and intravesical ureterocele underwent cystoscopic puncture under general anesthesia.
- Follow-up included renal ultrasound, Mag3 renography, and echocystography for 12-48 months.
Main Results:
- Drainage led to resolution of urinary infections in 5 patients and reduced hydronephrosis/megaureter.
- Improved differential renal function was observed in 2 patients; one required nephrectomy due to poor function.
- One case of postoperative vesicoureteral reflux was noted.
Conclusions:
- Cystoscopic drainage is an effective method for managing intravesical ureterocele in duplex systems.
- The procedure successfully reduces urinary tract infections and urinary tract dilation, aiding in renal function preservation.
Purpose:
To evaluate the clinical status and renal function of pa- tients with duplex system and intravesical ureterocele after drainage by cystoscopy.
Material And Methods:
In 9 patients with duplex system and intravesical ureterocele drainage was performed to present recurrent urinary tract infections (7 children with episodes of pyelonephritis and sepsis) or obstruction of the urinary drainage. The mean age was 33 months (range 8-108 months). The thecnique was done under general anesthesia in the operating room and puncture of the ureterocele was performed using cystourethroscopy with loop electrode. The minimum follow-up was 12 months (range 12-48 months) and includes renal ultrasound, renal isotopic study (Mag3 with furosemide) and-echocystography study in patients with preoperative vesicoureteral reflux or postoperative urinary tract infection.
Results:
The average operative time was 60 minutes. Mean hospital stay was 48 hours. There were no complications during the procedure. In five patients urinary infection episodes disappeared. Ultrasound demonstrated decreased hydronephrosis and megaureter. In two patients the differential renal function following the technique improved. One patient with preoperative split renal function of 14% required nephrectomy. One patient had postoperative vesicoureteral reflux.
Conclusions:
The drainage of intravesical ureterocele in patients with duplex system reduces episodes of urinary tract infection and urinary tract dilation.
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