The paraureteric diverticulum in childhood.

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.