Post-surgical assessment of lower urinary tract dysfunction in ureterocele patients

The primary aim of this analysis was to assess LUTD in ureterocele patients using validated questionnaire data.

The authors queried the electronic medical records (EMR) at a tertiary center for ureterocele patients (01/01/2002-12/31/2021). Families were prospectively contacted to complete the Dysfunctional Voiding Symptom Score (DVSS), a 10-question survey validated to assess LUTD. The primary outcome was LUTD rate. Secondary outcomes included demographics, ureterocele characteristics, surgical history, and individual DVSS items.

Of 123 eligible, 70 (57%) completed the DVSS. Median age at survey completion was 10.5 years (IQR 7-16). Most were female gender (67.1%). There were 27 respondents (38.6%) with DVSS scores consistent with significant LUTD. Individual items with the highest scores were holding urine and pushing to defecate. Most respondents (87.1%) underwent transurethral incision of ureterocele for initial management at median age 3 months (0-9.5). Thirty respondents (42.9%) had subsequent major reconstructive surgery at median age 17 months (13-32). Respondents who underwent reconstructive surgery involving the bladder had higher median DVSS scores compared to respondents who underwent endoscopic incision alone (p = 0.02). There were no differences in DVSS scores between genders, ureterocele location, UTI status, VUR status, or number of surgeries performed (p > 0.05).

The rate of LUTD identified in ureterocele patients was high, affecting 38.6% of respondents over a 20-year period. Most common dysfunction areas included holding urine and straining to defecate. Patients of all ages and genders were affected, but higher voiding dysfunction rates may be seen in those who undergo reconstructive surgery.