Related Experiment Video
Updated: Aug 23, 2025
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Risk factors for postoperative adverse outcomes and secondary surgery in pediatric patients with unilateral ectopic
1Department of Pediatric Urology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang City, Liaoning province 110004, China.
Insights
Transurethral endoscopic incision or puncture for ectopic ureterocele in children is linked to adverse outcomes like new-onset vesicoureteral reflux. However, few patients required further surgery, suggesting it can be effective for upper urinary tract decompression.
Area of Science:
- Pediatric Urology
- Surgical Outcomes
- Urinary Tract Abnormalities
Background:
- Management of ectopic ureterocele in children lacks a clear consensus.
- Unilateral ectopic duplex system ureterocele presents complex treatment challenges.
Purpose of the Study:
- To identify risk factors for adverse outcomes and secondary surgery in pediatric patients with unilateral ectopic duplex system ureterocele.
- To evaluate the safety and efficacy of different surgical approaches.
Main Methods:
- Retrospective review of 75 pediatric patients with unilateral ectopic duplex system ureterocele.
- Analysis of demographic, surgical, and outcome data using multivariate logistic regression.
Main Results:
- Adverse outcomes occurred in 33.3% of patients, primarily new-onset vesicoureteral reflux (32.0%).
- Transurethral endoscopic incision or puncture independently increased the risk of adverse outcomes compared to upper pole partial nephrectomy.
- 9.3% of patients required secondary surgery.
Conclusions:
- Transurethral endoscopic incision or puncture effectively decompresses upper urinary tract obstruction in acute urosepsis.
- While associated with a high rate of new-onset vesicoureteral reflux, these procedures rarely necessitate secondary surgery.
Introduction:
Ectopic ureterocele management in children remains a controversial subject without a clear consensus. The purpose of this study was to explore the risk factors for adverse outcomes and secondary surgery in pediatric patients with unilateral ectopic duplex system ureterocele, a complex urinary system deformity with controversial treatment.
Materials And Methods:
We retrospectively reviewed 75 patients with unilateral ectopic duplex system ureterocele who underwent surgery at the Shengjing Hospital of China Medical University between January 1, 2008, and September 31, 2020. Demographic characteristics, preoperative data, surgical procedures, postoperative adverse outcomes, and secondary surgery were recorded. Adverse outcomes were defined as new-onset VUR and BOO after surgery. The risks of adverse outcomes and secondary surgery were evaluated using multivariate binary logistic regression and expressed as adjusted odds ratios with 95% confidence intervals.
Results:
Adverse outcomes occurred in 25 (33.3%) patients, including 24 (32.0%) with new-onset vesicoureteral reflux and 1 (1.3%) with bladder outlet obstruction. Seven (9.3%) patients required secondary surgery. The independent risk factors for adverse outcomes were transurethral endoscopic incision and transurethral endoscopic puncture (transurethral endoscopic incision vs. upper pole partial nephrectomy: OR = 11.049, P = 0.004; transurethral endoscopic puncture vs. upper pole partial nephrectomy: OR = 33.222, P = 0.002).
Discussion:
The definitive treatment for duplex system ureterocele remains controversial. We found that transurethral endoscopic incision or puncture was an independent risk factor for adverse outcomes. The main limitation of this study would be its retrospective nature and relatively short follow-up period. Furthermore, 30 children were younger than 5 years at last follow up, and thus, we could not efficiently evaluate their voiding function.
Conclusions:
Transurethral endoscopic incision or puncture is effective for decompressing the obstruction of the upper urinary tract in acute urosepsis in ectopic duplex system ureterocele. Although more than half of patients with unilateral ectopic duplex system ureterocele suffered from new-onset vesicoureteral reflux after transurethral endoscopic incision or puncture, few of them required secondary surgery.
More Related Videos
06:39Technical Modification of the Terminal Ureter During Total Transperitoneal Laparoscopic Nephroureterectomy for Upper Urinary Tract Urothelial Carcinoma
Published on: November 22, 2019
04:37Unilateral Ureteral Obstruction Model for Investigating Kidney Interstitial Fibrosis
Published on: April 25, 2025
Related Concept Videos
01:26Kidney Transplant II: Surgical Procedure
01:16Kidney Transplant III: Nursing Management
01:25Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications
01:25Urinary Tract Calculi VI: Surgical Management
01:28Urologic Endoscopic Procedure: Cystoscopic Examination