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Endoscopic Treatment of Vesicoureteral Reflux Associated With Ureterocele

2007; Lippincott Williams & Wilkins; Volume: 178; Issue: 4S Linguagem: Inglês

10.1016/j.juro.2007.03.170

1527-3792

Boris Chertin, Nochiparambil Mohanan, Amicur Farkas, Prem Puri,

Ureteral procedures and complications

No AccessJournal of UrologyClinical prize finalist1 Oct 2007Endoscopic Treatment of Vesicoureteral Reflux Associated With Ureterocele Boris Chertin, Nochiparambil Mohanan, Amicur Farkas, and Prem Puri Boris ChertinBoris Chertin , Nochiparambil MohananNochiparambil Mohanan , Amicur FarkasAmicur Farkas , and Prem PuriPrem Puri View All Author Informationhttps://doi.org/10.1016/j.juro.2007.03.170AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We determined the value of endoscopic treatment for vesicoureteral reflux associated with ureterocele. Materials and Methods: From 1984 to 2005, 109 children with a median age of 6 months underwent endoscopic ureterocele puncture. Ureterocele presented as a part of a duplex system in 97 of patients (89%) and as part of a single system in 12 (11%). Vesicoureteral reflux was seen to the lower ipsilateral moiety in 53 patients and in 32 contralateral kidneys (85 refluxing renal units). Puncture was performed with a 3Fr Bugbee electrode. High grade vesicoureteral reflux or breakthrough infection while on antibiotic prophylaxis served as the indication for the surgical correction of vesicoureteral reflux. Median followup after endoscopic correction was 10 years (range 1 to 21). Results: Spontaneous vesicoureteral reflux resolution following successful ureterocele puncture was seen in 36 of the 85 refluxing renal units (42%) and in 5 (6%) reflux was downgraded. The latter patients were withdrawn from antibiotic prophylaxis and they did well. A total of 33 refluxing renal units with vesicoureteral reflux into the lower moiety of the ureterocele kidney and 11 contralateral refluxing renal units underwent endoscopic correction. Reflux was corrected in 31 of the 44 refluxing renal units (70%) after a single injection and it resolved after a second injection in another 9 (21%). In 4 refluxing renal units (9%) endoscopic correction failed and open reimplantation was done. Of the 109 patients (13%) 14 had vesicoureteral reflux to the ureterocele moiety following endoscopic puncture. Of those patients endoscopic correction resolved reflux in 3, reflux resolved spontaneously in 5 and upper pole partial nephrectomy was performed in 4 due to a nonfunctioning moiety. The remaining 2 patients did well without antibiotic prophylaxis. Conclusions: Our data show that endoscopic treatment of vesicoureteral reflux associated with ureterocele is a simple, long-term effective and safe procedure, avoiding the need for open surgery in the majority of patients following endoscopic puncture of ureterocele. References 1 : Ureteral duplication, ectopy, and ureteroceles. In: Pediatric Urology. Edited by . 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Google Scholar 14 : Does prenatal diagnosis influence the morbidity associated with left in situ nonfunctioning or poorly functioning renal moiety after endoscopic puncture of ureterocele?. J Urol2005; 173: 1349. Link, Google Scholar Departments of Urology, Shaare Zedek Medical Centre, Jerusalem and Ben-Gurion University of Negev, Be'er Sheva, Israel, and Children's Research Centre, Our Lady's Hospital for Sick Children, University College Dublin (NM, PP), Dublin, Ireland© 2007 by American Urological AssociationFiguresReferencesRelatedDetailsCited ByCastagnetti M (2018) Re: Outcomes of Endoscopic Incision for the Treatment of Ureterocele in Children at a Single InstitutionJournal of Urology, VOL. 194, NO. 4, (1171-1172), Online publication date: 1-Oct-2015.Palmer B, Greger H, Mannas D, Kropp B and Frimberger D (2011) Comparison of Endoscopic Ureterocele Decompression Techniques. Preliminary Experience—Is the Watering Can Puncture Superior?Journal of Urology, VOL. 186, NO. 4S, (1700-1704), Online publication date: 1-Oct-2011.Merguerian P, Taenzer A, Knoerlein K, McQuiston L and Herz D (2010) Variation in Management of Duplex System Intravesical Ureteroceles: A Survey of Pediatric UrologistsJournal of Urology, VOL. 184, NO. 4S, (1625-1630), Online publication date: 1-Oct-2010.Renzo D, Ellsworth P, Caldamone A and Chiesa P (2010) Transurethral Puncture for Ureterocele—Which Factors Dictate Outcomes?Journal of Urology, VOL. 184, NO. 4S, (1620-1624), Online publication date: 1-Oct-2010. Volume 178Issue 4SOctober 2007Page: 1594-1597 Advertisement Copyright & Permissions© 2007 by American Urological AssociationKeywordsendoscopyvesico-ureteral refluxureteroceleureterhyaluronic acidMetricsAuthor Information Boris Chertin More articles by this author Nochiparambil Mohanan More articles by this author Amicur Farkas More articles by this author Prem Puri More articles by this author Expand All Advertisement PDF DownloadLoading ...