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Pediatric Surgery International

, Volume 34, Issue 5, pp 561–565 | Cite as

Does endoscopic puncture of ureterocele provide not only an initial solution, but also a definitive treatment in all children? Over the 26 years of experience

  • Jaber Jawdat
  • Shachar Rotem
  • Stanislav Kocherov
  • Amicur Farkas
  • Boris Chertin
Original Article

Abstract

Purpose

We have retrospectively evaluated all patients who underwent endoscopic puncture (EP) of ureterocele over the last 26 years with special reference to the need in the second intervention and disease-free status.

Methods

78 (69%) of the 112 patients following EP and completed follow-up were included. 51 (65%) were diagnosed prenatally and 27 (35%) postnatally. 46 patients (60%) had intravesical, while 32 (40%) had ectopic ureterocele. Median age at time of puncture was 4 months. Median time of the follow-up was 12 years (range 1–26 years), while 23 (30%) followed over 10 years and 15 (19%) completed adolescent period.

Results

Four children with ectopic ureterocele required secondary puncture. Ectopic ureterocele children had significantly more postoperative UTIs (13 (40%) ectopic vs 4 (19%) intravesical p = 0.047). 19 RRUs (44%) showed spontaneous resolution of VUR. 14 (18%) children required additional surgery: 7, endoscopic correction of VUR; 3, ureteral reimplantation and 4, partial nephrectomy. The need for additional surgery following puncture was higher in the group of children with ectopic ureterocele; however, this difference did not reach a statistical significance (p = 0.716).

Conclusions

Our data show that EP of ureterocele is a durable and long-term effective procedure in vast majority of the children.

Keywords

Ureterocele Endoscopic puncture Long-term follow-up 

Notes

Funding

This study did not receive any financial funding.

Compliance with ethical standards

Conflict of interest

The authors have no conflict of the interest with the discussed in the manuscript material and we do have nothing to disclose concerning this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent regarding the surgical procedure was obtained from the parents of all individual participants included in the study.

References

  1. 1.
    Chertin B, Fridmnas A, Hadas H (2001) Endoscopic puncture of ureterocele as a minimally invasive and effective long-term procedure in children. Eur Urol 39(3):332–336CrossRefPubMedGoogle Scholar
  2. 2.
    Glassberg KI, Braren V, Duckett JW, Jacobs EC, King LR, Lebowitz RL et al (1984) Suggested terminology for duplex system, ectopic ureters and ureteroceles. J Urol 132:1153–1155CrossRefPubMedGoogle Scholar
  3. 3.
    Chertin B, Rabinowitz R, Pollack A, Koulikov D, Fridmans A, Hadas-Halpern I et al (2005) Does prenatal diagnosis influence the morbidity associated with left in situ nonfunctioning or poorly functioning renal moiety after endoscopic puncture of ureterocele? J Urol 173(4):1349–1352CrossRefPubMedGoogle Scholar
  4. 4.
    Caldamone AA, Snyder HMcC III, Duckett JW (1984) Ureterocele in children: follow up of management with upper tract approach. J Urol 131:113–116CrossRefGoogle Scholar
  5. 5.
    Blyth B, Passerini-Glazel G, Camuffo C, Snyder HM III, Duckett JW (1993) Endoscopic incision of ureterocele: intra- vesical versus ectopic. J Urol 149:556–559CrossRefPubMedGoogle Scholar
  6. 6.
    Pfister C, Ravasse P, Barret E, Petit T, Mitrofanoff P (1998) The value of endoscopic treatment for ureteroceles during the neonatal period. J Urol 159:1006–1009CrossRefPubMedGoogle Scholar
  7. 7.
    Smith C, Gosalbez R, Parrott TS, Woodward JR, Broecker B, Massad C (1994) Transurethral puncture of ectopic ureteroceles in neonates and infants. J Urol 152:2110–2112CrossRefPubMedGoogle Scholar
  8. 8.
    Polito C, La Manna A, Rambaldi PF, Nappi B, Mansi L, Di Toro R (2000) High incidence of a generally small kidney and primary vesicoureteral reflux. J Urol 164:479–482CrossRefPubMedGoogle Scholar
  9. 9.
    Mor Y, Ramon J, Raviv G, Jonas P, Goldwasser B (1992) A 20-year experience with treatment of ectopic ureteroceles. J Urol 147:1592–1594CrossRefPubMedGoogle Scholar
  10. 10.
    Husmann DA, Ewalt DH, Glenski WJ, Bernie PA (1995) Ureterocele associated with ureteral duplication and a non-functioning upper pole segment: management by partial nephroureterectomy alone. J Urol 154:723–726CrossRefPubMedGoogle Scholar
  11. 11.
    Merguerian PA, Taenzer A, Knoerlein K, McQuiston L, Herz D (2010) Variation in management of duplex system intravesical ureteroceles: a survey of pediatric urologists. J Urol 184:1625–1630CrossRefPubMedGoogle Scholar
  12. 12.
    Wang MH, Greenfield SP, Williot P, Rutkowski J (2008) Ectopic ureteroceles in duplex systems: long-term follow up and’treat- ment-free’ status. J Pediatr Urol 4:183–187CrossRefPubMedGoogle Scholar
  13. 13.
    Renzo DD, Ellsworth PI, Caldamone AA, Chiesa PL (2010) Transurethral puncture for ureterocele-which factors dictate outcomes? J Urol 184:1620–1624CrossRefPubMedGoogle Scholar
  14. 14.
    Mariyappa B, Barker A, Samnakay N, Khosa J (2014) Management of duplex-system ureterocele. J Paediatr Child Health 50(2):96–99CrossRefPubMedGoogle Scholar
  15. 15.
    Cohen SA, Juwono T, Palazzi KL, Kaplan GW, Chiang G (2015) Examining trends in the treatment of ureterocele yields no definitive solution. J Pediatr Urol 11(1):29.e1-6CrossRefPubMedGoogle Scholar
  16. 16.
    Timberlake MD, Corbett ST (2015) Minimally invasive techniques for management of the ureterocele and ectopic ureter: upper tract versus lower tract approach. Urol Clin North Am 42(1):61–76CrossRefPubMedGoogle Scholar
  17. 17.
    Bolduc S, Upadhyay J, Restrepo R, Sherman C, Farhat W, Bagli DJ et al (2003) The predictive value of diagnostic imaging for histological lesions of the upper poles in duplex systems with ureteroceles. BJU Int 91:678–681CrossRefPubMedGoogle Scholar
  18. 18.
    Chertin B, Natsheh A, Fridmans A, Shenfeld OZ, Farkas A (2009) Renal scarring and UTI following successful endoscopic correction of vesicoureteral reflux. J Urol 182(4 Suppl):1703–1706CrossRefPubMedGoogle Scholar
  19. 19.
    Jesus LE, Farhat WA, Amarante AC, Dini RB, Leslie B, Bägli DJ et al (2011) Clinical evolution of vesicoureteral reflux following endoscopic puncture in children with duplex system ureteroceles. J Urol 186:1455–1459CrossRefPubMedGoogle Scholar
  20. 20.
    Gran CD, Kropp BP, Cheng EY, Kropp KA (2005) Primary lower urinary tract reconstruction for nonfunctioning renal moieties associated with obstructing ureteroceles. J Urol 173(1):198–201CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.The Department of Pediatric Urology, Faculty of Medical Science, Shaare Zedek Medical CentreHebrew UniversityJerusalemIsrael

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