Minimally invasive treatment of pediatric obstructive ureterocele: A 20-year experience

Abstract

Introduction: Ureterocele is a congenital malformation of the urinary tract, characterized by the cystic dilation of the terminal ureter. Its treatment is indicated in symptomatic patients. Over the years, surgical treatment has evolved from open surgeries to minimally invasive procedures. The aim of this study was to assess the long-term outcomes of a case series involving pediatric patients with ureterocele, who were treated using an endoscopic puncture. Material and methods: A retrospective review was performed of ureterocele patients treated by endoscopic puncture from 2002 to 2021. The primary outcome of the study was relief of the obstruction with a single endoscopic puncture. Results: From 2002 to 2021, a total of 34 patients with 39 ureteroceles underwent treatment using this technique. The mean age at diagnosis was 16 months. Diagnoses was made prenatally through an ultrasound revealing a dilated urinary tract in 17/34 (50 %) of patients and during the assessment of a urinary tract infection in 15/34 (44 %) of patients. A duplex collecting system was observed in 28/34 (82 %) of patients, while bilateral ureteroceles were found in 5/34 (15 %) of patients. A single endoscopic puncture of the ureterocele proved to be successful in 27/34 (79 %) of patients. A second endoscopic puncture was needed in 4/34 (12 %). Only 3/34 (9 %) patients required a surgical intervention. The mean follow-up period was 4 years. Conclusion: The results of our study show that endoscopic puncture of obstructive ureterocele is a procedure with excellent long-term results.

Keywords

• Ureterocele
• Endoscopic puncture
• Duplex collecting system
• Vesicoureteral reflux
• Minimally invasive