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[The ureterocele in childhood. Type of treatment and results]
Insights
Ureteroceles, or urinary sac protrusions, are rare but severe in children. Surgical treatment, particularly for ectopic ureteroceles in duplex systems, is complex but manageable with a specific one-stage approach.
Area of Science:
- Pediatric Urology
- Congenital Urinary Tract Malformations
Background:
- Ureterocele is an uncommon pediatric urinary malformation.
- It often presents with significant clinical severity, especially within duplex pyelo-ureteral systems.
- Management of ureteroceles in these complex systems poses significant treatment challenges.
Purpose of the Study:
- To report the authors' experience in managing ureteroceles in pediatric patients.
- To evaluate treatment outcomes for simple and ectopic ureteroceles.
- To identify effective surgical strategies for complex cases.
Main Methods:
- Retrospective analysis of 79 ureteroceles in 72 children.
- Categorization of ureteroceles into simple and ectopic types.
- Surgical intervention including unroofing, heminephroureterectomy, and ureteral reimplantation.
Main Results:
- Simple ureteroceles without collecting system duplication were surgically uncomplicated.
- Ectopic ureteroceles, frequently associated with pyeloureteral duplication, presented surgical challenges.
- A one-stage surgical approach involving ureterocele unroofing and upper heminephroureterectomy, with optional lower ureteral reimplantation, yielded the best results.
Conclusions:
- Ectopic ureteroceles in pediatric patients require individualized treatment strategies.
- The described one-stage surgical technique is effective for the majority of ectopic ureteroceles.
- This approach offers successful management for complex uretero-pyeloureteral malformations in children.
Abstract:
Ureterocele is an infrequent urinary malformation in pediatric age, but it is frequently clinically severe. Ureterocele in a duplex pyelo-ureteral system often presents very difficult treatment problems not uniformly dealt with. Authors report their experience with 79 ureteroceles observed in 72 children. 27 children were less than one year old. In the authors experience simple ureterocele with a single collecting system doesn't give any surgical problem. On the contrary ectopic ureterocele, almost always associated with a pyeloureteral duplication, frequently gives some problems of surgical treatment. Treatment is always individualized but in our experience the best results have been achieved with unroofing of the ureterocele and upper heminephroureterectomy in one stage, eventually associated with lower ureteral reimplantation. This treatment can be used successfully in the majority of ectopic ureteroceles in pediatric age.