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Surgical patterns in the endoscopic management of pediatric ureterocele: A systematic review and meta-analysis

Hanieh Salehi-Pourmehr1, Behzad Lotfi2, Mohsen Mohammad-Rahimi2

  • 1Research Center for Evidence-based Medicine, Iranian EBM Centre: A JBI Centre of Excellence, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran; Medical Philosophy and History Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

Journal of Pediatric Urology
|May 5, 2024
PubMed

Insights

Ectopic ureteroceles and duplex systems lead to higher reoperation rates after endoscopic treatments. This systematic review highlights key factors influencing outcomes in ureterocele management.

Area of Science:

  • Urology
  • Pediatric Urology
  • Surgical Outcomes

Background:

  • Ureteroceles are congenital anomalies of the upper urinary tract.
  • Endoscopic management is a common treatment modality for ureteroceles.
  • Understanding factors influencing treatment success is crucial for patient care.

Purpose of the Study:

  • To evaluate endoscopic ureterocele treatment outcomes.
  • To determine the impact of ureterocele location (intravesical vs. ectopic) on success rates.
  • To assess the influence of urinary system anatomy (single vs. duplicated) on reoperation rates.

Main Methods:

  • Systematic review and meta-analysis adhering to PRISMA standards.
  • Inclusion of studies on endoscopic transurethral incision and puncture for ureteroceles.
  • Comparative analysis based on ureterocele location, system anatomy, and preoperative reflux.

Main Results:

  • Analysis of 83 studies involving 3022 patients.
  • Higher reoperation risk for ectopic ureteroceles compared to intravesical ones (RR: 2.42).
  • Increased reoperation rates observed in duplex system ureteroceles versus single system ureteroceles (RR: 2.50).

Conclusions:

  • Ectopic ureteroceles are associated with significantly higher reoperation rates.
  • Duplex system ureteroceles also demonstrate a higher likelihood of requiring reoperation.
  • These findings emphasize the importance of anatomical factors in endoscopic ureterocele treatment planning.
Abstract

Keywords:
EndoscopyUreteroceleVesicoureteral reflux

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