Management of duplex-system ureterocele

J Paediatr Child Health. 2014 Feb;50(2):96-9. doi: 10.1111/jpc.12474. Epub 2013 Dec 23.

Abstract

Aim: To analyse different treatment modalities, functional outcome and continence in children treated for duplex-system ureterocele and to review the relevant literature.

Methods: The medical records of patients with duplex-system ureterocele treated between 2001 and 2011 were reviewed retrospectively.

Results: Twenty-two cases were identified. Five patients underwent incision of the ureterocele as initial procedure. It was curative in only one patient. Seven patients underwent upper-pole nephroureterectomy. It was curative in 4 cases. Five patients underwent excision of ureterocele and common-sheath reimplant, and the remaining 5 patients had upper-pole nephroureterectomy and simultaneous excision of ureterocele with lower-moiety ureteric reimplantation. These surgeries were curative in all patients. Follow-up ranged from 4 to 84 months. Functional outcome was good in all patients. Fourteen patients were continent at follow-up, and continence was not assessed in the other 8 because of young age.

Conclusions: Our data suggest a higher rate of secondary procedures if there is retained ureterocele. Data also suggest that complete reconstruction can be safely performed in a young infant without any adverse effect on continence.

Keywords: common sheath reimplant; duplex ureterocele; endoscopic incision; secondary surgery; upper pole nephrectomy.

MeSH terms

  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Nephrectomy
  • Reoperation
  • Retrospective Studies
  • Ureter / surgery
  • Ureterocele / complications
  • Ureterocele / surgery*
  • Urinary Incontinence / etiology
  • Urinary Tract Infections / etiology