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Endoscopic and minimal open surgical incision of ureteroceles
C Pesce1, L Musi, P Campobasso
1Department of Pediatric Surgery, S. Bortolo Hospital, Vicenza, Italy.
Insights
Endoscopic or open incision effectively treats most pediatric ureteroceles, offering functional recovery and fewer infections. This approach is a definitive option for intravesical types and a valid initial step for ectopic ureteroceles.
Area of Science:
- Pediatric Urology
- Surgical Interventions
- Urological Conditions
Background:
- Ureteroceles are congenital abnormalities of the ureter.
- Management of pediatric ureteroceles can be complex, with varying treatment approaches.
- Incidence of intravesical and ectopic ureteroceles differs, potentially impacting treatment outcomes.
Purpose of the Study:
- To evaluate the efficacy of endoscopic or open incision for ureterocele decompression in children.
- To compare outcomes between intravesical and ectopic ureteroceles treated with incision.
- To determine the long-term effectiveness and necessity of secondary surgeries.
Main Methods:
- Retrospective analysis of 59 children with 63 ureteroceles.
- Primary treatment involved endoscopic or open incision.
- Classification of ureteroceles as intravesical or ectopic.
Main Results:
- Incision successfully decompressed all 18 intravesical ureteroceles.
- Eighty-two percent (37/45) of ectopic ureteroceles were adequately decompressed by incision.
- Secondary operation rates were 17% for intravesical and 62% for ectopic ureteroceles post-incision.
Conclusions:
- Endoscopic or open incision is a definitive treatment for most intravesical ureteroceles.
- Incision is a valid primary approach for ectopic ureteroceles, facilitating functional recovery and reducing infections.
- Early decompression via incision aids subsequent surgical reconstruction when necessary.
Abstract:
Ureterocele decompression by endoscopic or open incision was the primary treatment in 59 children with 63 ureteroceles. Of these, 18 were intravesical and 45 were ectopic. The endoscopic or open incision adequately decompressed all intravesical ureteroceles and 37 of 45 ectopic ureteroceles (82%). After incision, the secondary operation rate was 17% for intravesical and 62% for ectopic ureteroceles. In our opinion, endoscopic or open incision must be considered a definitive treatment in the large majority of intravesical ureteroceles and is also valid in ectopic ureteroceles. In these cases, the early decompression obtained by this approach produced significant functional recovery, fewer urinary tract infections, and facilitated subsequent surgery in those patients requiring complete surgical reconstruction.