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Ureteroceles in infants and children
Insights
Treatment for childhood ureteroceles requires individualization based on presentation and anatomy. Surgical options vary, with excision and reimplantation for simple cases and heminephrectomy for ectopic ureteroceles with poor upper pole function.
Area of Science:
- Pediatric Urology
- Surgical Management
- Congenital Anomalies
Background:
- Ureteroceles present with diverse clinical features and pathophysiology in children.
- Individualized treatment approaches are essential for optimal outcomes.
- A spectrum of surgical interventions exists for managing ureteroceles.
Purpose of the Study:
- To evaluate the presentation, radiographic findings, operative management, and outcomes of ureteroceles in a pediatric cohort.
- To discuss the indications for various surgical techniques in the management of childhood ureteroceles.
Main Methods:
- Retrospective review of 64 children with 72 ureteroceles who underwent surgical intervention.
- Analysis of patient presentation, imaging, surgical procedures, and postoperative results.
Main Results:
- Simple or orthotopic ureteroceles may not require surgery unless obstructive.
- Excision and ureteral reimplantation are recommended for obstructive simple ureteroceles.
- Upper pole heminephrectomy and partial ureterectomy are preferred for ectopic ureteroceles with poorly functioning upper renal segments.
Conclusions:
- Individualized surgical management is crucial for pediatric ureteroceles.
- Treatment selection depends on ureterocele type, location, and associated renal function.
- Current surgical options provide effective management for a wide range of ureterocele presentations.
Abstract:
Ureteroceles in childhood have a broad spectrum of presentation, anatomy and pathophysiology and, thus, treatment must be individualized. We evaluated 64 children with 72 ureteroceles who underwent operation. Their presentation, radiographic findings, operative management and postoperative results are discussed. Simple or orthotopic ureteroceles often require no operation unless they are large enough to obstruct the urinary tract. Then excision of the ureterocele and ureteral reimplantation are recommended. There are a number of options available for the management of ectopic ureteroceles. The procedure of choice is upper pole heminephrectomy and partial ureterectomy in the majority of ureteroceles associated with a poorly functioning upper renal segment. Specific indications for each of the other surgical techniques considered acceptable at present are discussed.