Management and outcomes of ureteroceles in children: An experience of 25 years

Vishesh Jain; Sandeep Agarwala; Anjan Dhua; Aparajita Mitra; Deepak Mittal; Divya Murali; Devasenathipathy Kandasamy; Rakesh Kumar; Veereshwar Bhatnagar

doi:10.4103/iju.IJU_522_20

Management and outcomes of ureteroceles in children: An experience of 25 years

Indian J Urol. 2021 Apr-Jun;37(2):163-168. doi: 10.4103/iju.IJU_522_20. Epub 2021 Apr 1.

Authors

Vishesh Jain¹, Sandeep Agarwala¹, Anjan Dhua¹, Aparajita Mitra¹, Deepak Mittal¹, Divya Murali¹, Devasenathipathy Kandasamy², Rakesh Kumar³, Veereshwar Bhatnagar¹

Affiliations

¹ Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India.
² Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India.
³ Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India.

Abstract

Introduction: Ureterocele is a rare urogenital malformation. The treatment is variable and complicated as it depends on several factors. The aim of this study was to evaluate the management and outcomes of children with ureterocele and to compare single system and duplex system ureteroceles.

Materials and methods: A retrospective study was conducted and all patients with ureterocele operated from January 1992 to December 2018 were included. The records of those included were assessed, and a detailed case record sheet was filled. The outcome parameters assessed were the persistence of symptoms and additional surgical procedure performed.

Results: Forty-seven patients (28 boys and 19 girls) with a median age of presentation of 21 months were included. Four patients had bilateral ureterocele. Overall, 51 renal units with ureterocele were studied. Twenty renal units of the 31 renal units with duplex system underwent cystoscopic decompression, and of these, 8 (40%) needed a second procedure. Fourteen renal units of the remaining 20 renal units with single system underwent cystoscopy and decompression, and of these, 1 (7%) required another procedure (P = 0.024). Sixteen renal units had ectopic ureterocele, of which 9 (56%) underwent heminephrectomy/nephrectomy. Intravesical ureterocele was present in 35 renal units, of which only 2 (5.7%) underwent nephrectomy or heminephrectomy (P < 0.001).

Conclusion: Duplex system ureteroceles are more likely to require a second procedure following an endoscopic puncture. Units with ectopic ureterocele were more likely to need nephrectomy.