Outcomes of duplex system ureteroceles in pediatric patients managed primarily with transurethral incision

@#Transurethral incision of ureterocele (TUI-U) is a simple, quick, less invasive, and less expensive,and an effective procedure for the management of ureteroceles. Several studies have already shownits utility for primary management of ureteroceles but it has also been associated with the need foradditional surgery. The authors reviewed charts of patients from their database to describe the outcomesof TUI-U done in ureteroceles associated with the upper pole moiety of a duplex system. They alsolooked into preoperative patient characteristics and post TUI-U outcomes that could influence theneed for subsequent surgeries.@*MATERIALS AND METHODS@#The authors identified patients from their duplex system database who presentedwith a ureterocele and underwent TUI-U. They reviewed the patient records of 25 patients who wereincluded in the study to determine the outcomes of TUI-U in duplex system ureteroceles. Chi squareand Mann Whitney U tests were used to determine whether preoperative patient features and postTUI-U outcomes were associated with secondary surgery.@*RESULTS@#Out of 65 patients who had duplex system ureteroceles, 25 patients (38.4%) underwent TUI-U at a mean age of 1.51 years old. TUI-U alone was successful in improving the prevalent signs andsymptoms of 15 patients (60%) in this group, while 10 patients (40%) had to undergo subsequentsurgical procedures. Breakthrough urinary tract infection (UTI) post TUI-U was the only patientfactor noted to be significantly associated with a secondary surgery for duplex system ureterocele(p=0.027).@*CONCLUSION@#TUI-U as primary treatment for duplex system ureteroceles is not yet widely accepteddue to reported rates of morbidities and need for secondary surgery. Present data however show thatTUI-U can be used as a primary procedure and even as a definitive procedure for this subset ofpatients with remarkable results in terms of symptoms resolution and improvement of upper tract profiles.

Ureteral Surgery and Complication / 대한비뇨기과학회지

Ureteral surgery is one of the most common operation in urinary tract, for that reason, the postoperative clinical progress and complications are various and complicate. A retrospective study was`conducted on 153 patients who had undergone ureteral surgery, which were ureterolithotomy (69), ureteral instrumentation for lower ureteral stone (72), ureteroneocystostomy (5), urinary diversion (5), ureteroplasty (1) and ureterectomy combined with ureterocelectomy (1). Various complications occured in 57 patients of total 153 patients who had undergone ureteral surgery. The most common complications of each of ureterolithotomy and ureteral instrumentation as the common ureteral surgery were 21 cases (30.4%) of urinary leakage among 69 ureterolithotomies and 13 cases (18.1%) of gross hematuria among 72 ureteral instrumentations.