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[Ureterocele: study of 66 cases observed in 60 children]
Insights
Pediatric ureteroceles, especially ectopic types in duplicated systems, pose surgical challenges. A one-stage unroofing and upper heminephroureterectomy offers successful treatment for most cases in young children.
Area of Science:
- Pediatric Urology
- Urologic Surgery
- Congenital Urinary Tract Abnormalities
Background:
- Ureterocele is a rare but often severe congenital urinary malformation in children.
- Ectopic ureteroceles, frequently associated with pyeloureteral duplication, present complex surgical management issues.
Purpose of the Study:
- To report the authors' experience in managing pediatric ureteroceles.
- To evaluate the efficacy of a specific surgical approach for ectopic ureteroceles in children.
Main Methods:
- Retrospective review of 66 ureteroceles in 60 pediatric patients.
- Surgical treatment involved individualized approaches, with a focus on unroofing the ureterocele and one-stage upper heminephroureterectomy for ectopic cases.
Main Results:
- Simple ureteroceles were surgically uncomplicated.
- Ectopic ureteroceles, particularly those in duplicated systems, demonstrated significant surgical challenges.
- The combined procedure of ureterocele unroofing and upper heminephroureterectomy yielded the best outcomes in the majority of treated ectopic ureteroceles.
Conclusions:
- While simple ureteroceles are manageable, ectopic ureteroceles require tailored surgical strategies.
- A one-stage unroofing of the ureterocele combined with upper heminephroureterectomy is an effective treatment for pediatric ectopic ureteroceles.
Abstract:
Ureterocele is an unfrequent urinary malformation in pediatric age, but frequently it is clinically severe. Ureterocele in a double pyelo-ureteral system often presents very difficult treatment problems not uniformely dealt with. Authors report their experience with 66 ureteroceles observed in 60 children; more than a half of which were less than one year old. In the authors experience simple ureterocele does'nt give any surgical problem. On the contrary ectopic ureterocele, almost always associated with a pyeloureteral duplication, frequently gives some problems of surgical treatment. Treatment is always individualized but in our experience the best results have been achieved with unroofing of the ureterocele and upper heminephoureterectomy in one stage. This treatment can be used successfully in the majority of ectopic ureteroceles in pediatric age.