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Ureteroceles in children: followup of management with upper tract approach
Insights
Management of ureteroceles in children can lead to complications. A study found that upper pole heminephrectomy alone for ureteroceles resulted in a high rate of persistent reflux, indicating potential issues with this surgical approach.
Area of Science:
- Pediatric Urology
- Nephrology
- Surgical Outcomes
Background:
- Ureteroceles are congenital anomalies that can cause urinary tract obstruction and reflux.
- Management strategies for ureteroceles are varied and often debated.
- Secondary operative rates following initial ureterocele treatment require further investigation.
Purpose of the Study:
- To evaluate the secondary operative rate in children treated with upper pole heminephrectomy alone for ureteroceles.
- To assess the incidence of persistent reflux after this specific surgical intervention.
Main Methods:
- Retrospective analysis of 58 children diagnosed with ureteroceles.
- Focus on patients who underwent upper pole heminephrectomy as the primary treatment.
- Follow-up examinations to determine secondary operative rates and reflux incidence.
Main Results:
- A higher than anticipated rate of persistent reflux was observed in patients initially managed with upper pole partial nephrectomy and partial ureterectomy.
- This suggests that upper pole heminephrectomy alone may not adequately address or may even exacerbate reflux in some cases.
Conclusions:
- Upper pole heminephrectomy alone for ureteroceles may be associated with a significant incidence of persistent reflux.
- Further research is needed to optimize surgical strategies for ureteroceles to minimize secondary operative interventions and complications.
Abstract:
Ureteroceles can be associated with obstruction and/or reflux to any of the involved renal units. Their management is controversial and the possible options are numerous. From a population of 58 children with ureteroceles we analyzed those patients who underwent upper pole heminephrectomy alone as to the secondary operative rate. Followup examination of those patients whose management was initiated with upper pole partial nephrectomy and partial ureterectomy revealed a higher than expected incidence of persistent reflux.