Transvesicoscopic Reconstruction for Duplex Ectopic Ureterocele: A Minimally Invasive Alternative to Open Surgery

Ectopic ureterocele in duplex systems is commonly treated with open reconstruction, despite advances in minimally invasive pediatric urology. We developed a fully intravesical transvesicoscopic technique that reproduces key elements of open repair, including mucosa-preserving marsupialization, ureteral tapering, and common-sheath reimplantation. This study evaluated the feasibility and safety of this approach compared with open surgery. Between 2006 and 2023, eight children underwent definitive reconstruction (four open, four transvesicoscopic). All had prior ureterocele decompression and subsequent vesicoureteral reflux. The transvesicoscopic group had longer operative times but shorter hospitalization and did not require routine ureteral stenting. Vesicoureteral reflux resolved in all upper-pole systems, and hydronephrosis improved in all cases. No major complications or reoperations occurred, and renal function remained stable. In selected pediatric patients, transvesicoscopic reconstruction is a feasible and minimally invasive alternative that can replicate essential elements of open surgery with comparable early outcomes.