Management of double system ureterocele

Thirty eight patients with double system ureterocele are reviewed. More than half presented in infancy, urinary infection being the commonest clinical feature. Urinary tract ultrasound (US) and renal nuclide scan (RNS) were found to be the most useful diagnostic investigations. Whereas there are various surgical options available, an analysis of the results indicates that the primary operation should usually be an upper pole heminephrourterectomy, particularly in infancy. Secondary bladder surgery will be necessary in many infants but in children with disease confined to the ureterocele segment only, bladder surgery may be avoided. In selected cases, usually beyond infancy, total one stage reconstruction with upper pole heminephroureterectomy and bladder surgery may be justified.