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[Corrective operations in ureterocele in children]
Insights
This study details ureterocele treatment in 59 children. Congenital ureteroceles, often part of distal ureter malformations, require tailored surgical approaches based on ureteral dilatation and structural changes.
Area of Science:
- Pediatric Urology
- Congenital Urologic Abnormalities
- Surgical Management
Background:
- Ureterocele is a congenital condition involving a cyst-like dilation of the distal ureter.
- It can occur in single or double ureter systems and is often associated with other ureteral malformations.
- Understanding structural changes is key to effective treatment strategies.
Observation:
- The study reviewed 59 pediatric cases (3 months-14 years) of ureterocele.
- Ureteroceles were found to be congenital, frequently part of complex distal ureter malformations.
- Structural changes ranged from mild to severe ureteral dilatation.
Findings:
- Treatment policy was based on ureteral dilatation and structural integrity.
- For normal megaureters with significant dilatation, distal ureter resection, ureterocele modeling, and reimplantation were performed.
- Minor pelvic ureter dilatation (<1.0-1.5 cm) allowed for less invasive endovesical electroperforation.
Implications:
- Tailored surgical strategies based on ureteral anatomy and pathology are crucial for successful ureterocele treatment.
- Minimally invasive techniques like electroperforation can be effective for select cases.
- This approach addresses congenital ureterocele as a component of distal ureter malformations.
Abstract:
The authors analyze their experience in the treatment of 59 children aged 3 months--14 years with ureterocele of the single (22 patients) and double ureter (37 patients). Examination and surgical data showed that ureterocele in the operated on children was congenital and became a component of a complicated malformation of the distal ureter. Structural changes varied from minimal to total dysplasia reflected in the degree of the ureteral dilatation. These changes were characteristic for both normal and double ureters and served the base for treatment policy decision. In normal megaureter the authors performed resection of the distal ureter as well as ureterocele, modelling and neoplantation of the proximal segment according to the antireflux technique. Minor dilatation of the pelvic ureter (up to 1.0-1.5 cm dependent on the patient's age) indicated that structural alterations of its wall are confined to the submucosal segment. In view of this, surgical intervention involved only endovesicular electroperforation of ureterocele. The policy in the double ureter ureterocele was based on the same criteria.