Risk Factors for Recurrent Urinary Tract Infections After Endoscopic Incision of Ureterocele in Infant

To clarify the impact of endoscopic incision for ureterocele as an initial procedure, focusing on end points of postoperative recurrent febrile urinary tract infections (UTIs) and need for second surgery.

Overall, 80 patients with ureterocele were retrospectively reviewed. We investigated patient preoperative radiological and clinical data and postoperative radiological and clinical outcomes.

All 80 patients who underwent endoscopic incision were identified and included in our study, and endoscopic incision was conducted at an average of 4.6 (IQR 2.5 to 8.5) months. Twenty-nine patients with ureterocele had postoperative recurrent febrile UTIs during the follow-up of 36months, and 20 out of 29 patients were recommended secondary intervention. Initial recurrent febrile UTIs in most child occurred <12months after endoscopic incision, the recurrent febrile UTIs-free rate after endoscopic incision was 63.75%. The risk factor for recurrent febrile UTIs were duplex system and vesicoureteral reflux (VUR) on postoperative voiding cystourethrography, early ureterocele decompression could improve renal function.

Endoscopic incision is optimal for instant ureterocele decompression to improve renal function, and it avoids a complete urinary tract reconstruction in most patients. Our results showed that duplex system and VUR postoperative VUR were risk factors for postoperative recurrent febrile UTIs for ureterocele. Compared to those with new-onset VUR, antibiotic prophylaxis treatment might be beneficial in ureterocele with preoperative VUR.