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Ureteroceles in children: clinical study and report of 58 cases
Insights
This study on ureteroceles in children found they are more common in females and often linked to urinary tract issues. Early management involves antibiotics and surgical intervention for effective treatment.
Area of Science:
- Pediatric Urology
- Congenital Malformations
- Urinary Tract Disorders
Background:
- Ureteroceles are congenital cystic dilatations of the terminal ureter.
- They can lead to significant urinary tract complications in children.
- Understanding their presentation and associations is crucial for timely intervention.
Purpose of the Study:
- To describe the clinical characteristics, associated anomalies, and management of ureteroceles in a pediatric cohort.
- To highlight the common presenting symptoms and diagnostic findings.
- To emphasize the importance of prompt and appropriate surgical management.
Main Methods:
- Retrospective review of 58 children diagnosed with ureteroceles.
- Analysis of patient demographics, lesion type, associated conditions, presenting symptoms, and diagnostic imaging.
- Evaluation of treatment strategies and outcomes.
Main Results:
- Ureteroceles predominantly affected females and the left urinary system.
- Ectopic ureteroceles, often associated with duplex systems, were most common.
- Urinary tract infections and abdominal masses were frequent presenting symptoms, with 50% exhibiting vesicoureteric reflux.
Conclusions:
- Ureteroceles frequently present with urinary infections or masses and are associated with obstruction or reflux.
- Management requires addressing infection and considering surgical excision or drainage.
- Complex ureteroceles necessitate specialized surgical expertise for optimal outcomes.
Abstract:
Fifty-eight children with ureteroceles are the subject of this study. The lesions occurred more commonly in females and affected the left urinary transport system predominantly. Ectopic ureterocele was the most common type and virtually always developed on the ureter originating from the upper renal unit of a duplex kidney. There was a high incidence of associated urinary tract obstruction or vesico-ureteral reflux. The most common presenting symptoms were those of urinary infection followed by discovery of an abdominal mass. A characteristic filling defect in the bladder was seen on excretory urogram, and voiding cystourethrography revealed vesicoureteric reflux in 50% of the patients. Management of an infant or child with a ureterocele should begin with appropriate antibiotic treatment if infection is present, followed by excision or drainage of the involved renal segment(s). A pus filled upper pole and ureter may need to be removed or drained urgently in some ill patients. Ureteroceles are often complicated anatomic problems, which should be treated by surgeons who are familiar with the various facets of this congenital malformation.
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