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Comparison of Endoscopic Ureterocele Decompression Techniques. Preliminary Experience—Is the Watering Can Puncture Superior?

2011; Lippincott Williams & Wilkins; Volume: 186; Issue: 4S Linguagem: Inglês

10.1016/j.juro.2011.04.007

1527-3792

Blake Palmer, Hubert Greger, Daniel B. Mannas, Bradley P. Kropp, Dominic Frimberger,

Ureteral procedures and complications

No AccessJournal of UrologyHydronephrosis1 Oct 2011Comparison of Endoscopic Ureterocele Decompression Techniques. Preliminary Experience—Is the Watering Can Puncture Superior? Blake W. Palmer, Hubert Greger, Daniel B. Mannas, Bradley P. Kropp, and Dominic Frimberger Blake W. PalmerBlake W. Palmer , Hubert GregerHubert Greger , Daniel B. MannasDaniel B. Mannas , Bradley P. KroppBradley P. Kropp , and Dominic FrimbergerDominic Frimberger View All Author Informationhttps://doi.org/10.1016/j.juro.2011.04.007AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: The optimal endoscopic technique to manage an obstructing ureterocele would reliably relieve obstruction without creating de novo vesicoureteral reflux. The classic incision achieves decompression but invariably creates new vesicoureteral reflux. We compared a new endoscopic puncture technique to assess its superiority to endoscopic incision. Materials and Methods: We retrospectively reviewed 27 consecutive endoscopic ureterocele procedures at our institution. Patients who underwent an endoscopic incision or watering can puncture procedure had their records reviewed for preoperative radiological and clinical data, operative description, and postoperative radiological and clinical outcomes. Results: Of the 15 patients with endoscopic ureterocele incision 11 underwent a watering can puncture. All ureteroceles were associated with grade 3 or 4 hydronephrosis. Incision successfully decompressed the ureterocele in 14 of 16 cases (87.5%) and hydronephrosis in 14 (87.5%) on postoperative renal ultrasound. De novo reflux was detected in 12 of 16 patients (75.0%) on postoperative voiding cystourethrogram. Puncture successfully decompressed the ureterocele in 10 of 11 cases (90.9%) and hydronephrosis in 9 (81.8%). De novo vesicoureteral reflux was detected in 4 of 11 patients (36.4%). Conclusions: Our initial review shows that the endoscopic watering can procedure successfully decompresses the obstructing ureterocele and its associated hydronephrosis. This technique also results in a decreased incidence of de novo vesicoureteral reflux and ultimately in fewer invasive procedures for the patient. References 1 : A meta-analysis of surgical practice patterns in the endoscopic management of ureteroceles. J Urol2006; 176: 1871. Link, Google Scholar 2 : Suggested terminology for duplex systems, ectopic ureters and ureteroceles. J Urol1984; 132: 1153. Link, Google Scholar 3 : Management of ectopic ureterocele associated with renal duplication: a comparison of partial nephrectomy and endoscopic decompression. J Urol1999; 162: 1406. Link, Google Scholar 4 : Does the endoscopic technique of ureterocele incision matter?. J Urol2004; 172: 684. Google Scholar 5 : Ultrasound grading of hydronephrosis: introduction to the system used by the Society of Fetal Urology. Pediatr Radiol1993; 23: 478. Google Scholar 6 : Voiding cystourethrogram—are our protocols the same?. J Urol2011; 186: 1668. Link, Google Scholar 7 : Endoscopic treatment of vesicoureteral reflux associated with ureterocele. J Urol2007; 178: 1594. Link, Google Scholar Department of Pediatric Urology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, and Department of Pediatric Surgery, Hospital of the Third Order (HG), Munich, Germany© 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byLopes R, Fernandez N, Koyle M, dos Santos J, Perez J, Romao R and Lorenzo A (2018) Clinical Outcomes of the Upper Urinary Tract after Ureteral Clipping for Treatment of Low Functioning or Nonfunctioning Renal MoietiesJournal of Urology, VOL. 199, NO. 2, (558-564), Online publication date: 1-Feb-2018. Volume 186Issue 4SOctober 2011Page: 1700-1704 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.Keywordsendoscopyureterocelevesico-ureteral refluxhydronephrosisureterMetricsAuthor Information Blake W. Palmer More articles by this author Hubert Greger More articles by this author Daniel B. Mannas More articles by this author Bradley P. Kropp More articles by this author Dominic Frimberger More articles by this author Expand All Advertisement PDF downloadLoading ...