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The paraureteric diverticulum in childhood
Insights
Paraureteric diverticulum is more common in males and often presents with urinary infections. Early diagnosis and conservative treatment are key, but surgical intervention may be needed for advanced cases.
Area of Science:
- Pediatric Urology
- Surgical Treatment
- Congenital Abnormalities
Background:
- Paraureteric diverticulum is a rare congenital anomaly.
- It is more prevalent in males and associated with urinary tract infections (UTIs).
- Associated findings include vesicoureteric reflux and double ureters, contributing to UTIs.
Purpose of the Study:
- To review the clinical features of paraureteric diverticulum in children.
- To evaluate the outcomes of surgical treatment for this condition.
- To determine the optimal management strategy based on disease stage.
Main Methods:
- Retrospective review of 27 children diagnosed with paraureteric diverticulum between 1969 and 1979.
- Analysis of clinical presentations, diagnostic methods, and treatment outcomes.
- Comparison of conservative versus surgical management approaches.
Main Results:
- Urinary infection was the most common presenting feature, linked to the diverticulum and associated anomalies.
- Excretion urography identified the diverticulum in only 2 patients, while micturating cystography confirmed it in 24.
- Conservative treatment with chemotherapy was effective for small diverticula without reflux.
Conclusions:
- Micturating cystography is the preferred diagnostic tool for paraureteric diverticulum.
- Conservative management is suitable for early-stage disease without vesicoureteric reflux.
- Surgical excision of the diverticulum with ureteral reimplantation is the treatment of choice for advanced cases.
Abstract:
The clinical features and the results of surgical treatment in 27 children with a paraureteric diverticulum treated between 1969 and 1979 were reviewed. The condition is commoner in males. Vesicoureteric reflux and double ureters were associated findings and together with the diverticulum accounted for the high incidence of urinary infection as a presenting feature. In only 2 patients with the diverticulum seen on excretion urography, but micturating cystography confirmed the diagnosis in 24 patients. Conservative treatment with continuous chemotherapy is satisfactory when the diverticulum is small and prior to the development of vesicoureteric reflux. In the later stages, excision of the diverticulum and reimplantation of the contiguous ureter is the surgical treatment of choice.