Orthotopic ureteroceles in children

Area of Science:

• Pediatric Urology
• Urologic Oncology

Background:

• Ureteroceles are congenital anomalies of the ureter.
• Simple ureteroceles can cause significant upper tract obstruction in children.

Purpose of the Study:

• To review experience with simple ureteroceles in children.
• To evaluate diagnostic methods and treatment outcomes.
• To recommend the optimal surgical approach.

Main Methods:

• Retrospective review of 20 simple ureteroceles in 18 children.
• Analysis of diagnostic imaging (excretory urography, cystography) and cystoscopy findings.
• Evaluation of surgical interventions and outcomes, including complications.

Main Results:

• Hydroureteronephrosis was present in most cases; 5 kidneys were non-functioning.
• Excretory urography showed cobra-head dilatation; cystography revealed filling defects with impaired renal function.
• Simple unroofing/incision led to vesicoureteral reflux and infection; nephroureterectomy was needed for non-functioning kidneys.

Conclusions:

• Surgical intervention is necessary for most symptomatic ureteroceles.
• Total ureterocele excision with ureteral reimplantation using an antireflux technique is the preferred method.
• This approach minimizes complications like vesicoureteral reflux and infection.