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Transurethral incision as initial option in treatment guidelines for ectopic ureteroceles associated with duplex systems

Authors
 Jee Soo Park  ;  Yong Seung Lee  ;  Cho Nyeong Lee  ;  Sung Hoon Kim  ;  Sang Woon Kim  ;  Hyeyoung Lee  ;  Sang Won Han 
Citation
 WORLD JOURNAL OF UROLOGY, Vol.37(10) : 2237-2244, 2019 
Journal Title
 WORLD JOURNAL OF UROLOGY 
ISSN
 0724-4983 
Issue Date
2019
Keywords
Duplex system ; Ectopic ureterocele ; Transurethral incision
Abstract
PURPOSE: Treatment strategies for children with ectopic ureteroceles (EUs) and duplex collecting systems or vesicoureteral reflux are controversial. Transurethral incision (TUI) of EUs associated with duplex systems has been considered only as a temporizing technique. This study aimed to evaluate whether primary TUIs could be considered as an initial treatment option in EUs with duplex systems. MATERIALS AND METHODS: Forty-seven children with EUs associated with duplex systems underwent primary TUIs at our institution between November 2007 and October 2017. We retrospectively analyzed patient characteristics such as age, sex, upper tract status, ureterocele location, differential renal function, and preoperative vesicoureteral reflux with regard to postoperative complications requiring additional surgery, postoperative incontinence, and renal function. RESULTS: The mean age at operation was 4.8 ± 4.7 months. Of the 47 patients, 26 (55.3%) underwent primary TUIs only, 3 (6.4%) underwent secondary TUIs, and 18 (38.3%) underwent other secondary procedures such as common-sheath reimplantation (CSR) and ureterocelectomy. Secondary surgeries in 21/47 (44.7%) patients occurred during a mean follow-up of 47.7 ± 23.3 months, and the most common type of secondary surgery was CSR. The most common reason for secondary surgery was febrile urinary tract infection (14/21 patients [66.7%]). There were three cases (3/26 [11.5%]) of voiding problems after primary TUI and two cases (2/15 [13.4%]) after secondary CSR. CONCLUSIONS: Primary TUIs should be considered as initial treatment options for EUs in duplex systems and not just a temporizing technique.
Full Text
https://link.springer.com/article/10.1007%2Fs00345-018-2607-x
DOI
10.1007/s00345-018-2607-x
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sang Woon(김상운) ORCID logo https://orcid.org/0000-0002-5790-1948
Park, Jee Soo(박지수) ORCID logo https://orcid.org/0000-0001-9976-6599
Lee, Yong Seung(이용승) ORCID logo https://orcid.org/0000-0003-3778-9888
Han, Sang Won(한상원) ORCID logo https://orcid.org/0000-0003-0941-1300
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/174858
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