Surgical therapy for both pediatric and adult ureteroceles may include any of the following:
- Endoscopic puncture
- Incision or transurethral unroofing of the ureterocele
- Upper pole heminephrectomy
- Excision of ureterocele and ureteral reimplantation
- Nephroureterectomy
What is the first-line treatment for ureterocele?
No single method works for every ureterocele, and may use one or a combination of the following techniques: Endoscopic Puncture Endoscopic puncture is typically the first-line treatment for single-system ureterocele, which is more common in boys than girls and is often intravesical (meaning the ureterocele is inside the bladder).
How is ureterocele surgery performed?
The following are treatment options: Surgery Transurethral Puncture. With this treatment, the ureterocele is punctured and decompressed. To do this a cystoscope (a thin tube with camaera and light on the end) is used. It usually takes 15 to 30 minutes and can be done without an overnight stay in the hospital. This treatment doesn't use a large incision.
What is endoscopic puncture surgery for ureterocele?
Mar 21, 2022 · Simple or complex intravesical ureteroceles underwent examination under anesthesia and endoscopic deroofing and DJ stenting for 3 weeks. Of a total of 36 children, 6 were presented with acute complications of ureterocele. They have been managed on an individualized optimum management plan.
Is laser energy effective for the treatment of ureterocele?
Apr 08, 2019 · Materials and methods:Decompression was performed by endoscopic multiple punctures at the basis of the ureterocele. Holmium YAG Laser was utilized with 0.5–0.8 joule energy, through 8–9.8F cystoscope under general anesthesia. The control group received ureterocele incision by diathermic energy through pediatric resettoscope.
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What is the best treatment for ureterocele?
How is it treated?losing weight to take stress off pelvic structures.avoiding heavy lifting.doing Kegel exercises, which are pelvic floor exercises that help strengthen the vaginal muscles.More items...•May 29, 2018
What is Ureteroscopy surgery?
Ureteroscopy is a procedure to address kidney stones, and involves the passage of a small telescope, called a ureteroscope, through the urethra and bladder and up the ureter to the point where the stone is located.
What is the outcome for surgical treatment to repair a ureterocele?
Results: Overall the reoperation rate in patients with intravesical ureterocele was 22% and 23% in those treated with initial endoscopic incision or puncture. In patients with extravesical ureterocele the reoperation rate was 100, 41 and 0% in groups 1 to 3, respectively.
How is ureterocele diagnosed?
Ureteroceles are often diagnosed by prenatal ultrasound where a dilated ureter and kidney (or upper part of a kidney) and a cystic structure (the ureterocele) in the bladder is seen. Ureteroceles can also be found by ultrasound after a child has a urinary tract infection or other reason to obtain a renal ultrasound.
Is ureteroscopy a major surgery?
Ureteroscopy is a minimally invasive method to treat kidney stones as well as stones located in the ureter. It is performed in the operating room with general or spinal anesthesia, and is typically an out-patient procedure (you go home the same day).
How painful is a ureteroscopy?
Most ureteroscopy patients have mild to moderate pain that can be managed with medications. To relieve mild pain: You should drink two eight-ounce glasses of water every hour in the two hours after the procedure.Feb 8, 2021
What is a ureterocele in medical terms?
A ureterocele is a swelling at the bottom of one of the ureters. Ureters are the tubes that carry urine from the kidney to the bladder. The swollen area can block urine flow. A ureterocele is a birth defect.Oct 8, 2020
Can a ureterocele go away on its own?
In most cases, if there is reflux up the ureter into the lower part of the kidney, the reflux should be treated. It is unlikely to disappear with time. If this is the case, removal of the ureterocele and ureteral re-implantation (recreation of the flap valve) is recommended.
How common is ureterocele?
That bulge or pouch is called a ureterocele. Ureteroceles are birth defects that occur in approximately 1 out of every 2,000 babies. They occur most often in Caucasians. A ureterocele is 10 times more common in girls than in boys, because a duplex collecting system (two ureters for one kidney) is more common in girls.
Does ureterocele need treatment?
A ureterocele is a congenital (from birth) disorder in which the ureter develops an out-pouching as it enters the bladder. Treatment of the ureterocele usually involves the placement of a stent to relieve the obstruction and/or surgical repair.
What are symptoms of ureterocele?
What are the symptoms of a ureterocele?Painful urination and/or burning feeing while urinating.Bad-smelling urine.Pain and/or a lump in the abdominal area.Blood in the urine.Fever.Urinating often.Urinary incontinence (inability to hold urine).Not being able to empty the bladder.Nov 6, 2020
Can you fix a urethrocele?
Unless another health problem is present that would require an abdominal incision, the bladder and urethra are usually repaired through an incision in the wall of the vagina. This surgery pulls together the loose or torn tissue in the area of prolapse in the bladder or urethra and strengthens the wall of the vagina.
What is ureterocele?
Ureterocele is a congenital anomaly (present at birth) that affects girls more than boys. It is simply a swelling limited to the end of the ureter as it enters the bladder. The swelling resembles a balloon on ultrasound or during a camera examination of the bladder.
What are the complications of ureterocele?
What are some complications of an ureterocele? The main problem from ureterocele is kidney damage, and kidney infection. Urine blockage may damage the developing kidneys and reduce their ability to filter. Ref lux of urine backward to the kidney is also common, especially when there are two ureters in one kidney.
How to diagnose a syphilis?
Ultrasound is the first imaging test used to find this condition. Other imaging studies may be done to help understand what’s happening, and for treatment. For an infant or small child, the following tests may be done: 1 A voiding cystourethrogram ( VCUG) may be done to see the bladder in action. This is a series of X-rays of the bladder and lower urinary tract taken with a special dye. First a catheter is inserted in the urethra to fill the bladder with a water-based dye. It is removed. Then several X-rays are taken as the patient empties the bladder. These images allow radiologists to find problems in the flow of urine through the body. 2 When a ureterocele has been found, it is also important to evaluate the kidneys for damage and evidence for blockage to urine flow across the ureterocele. A nuclear renal scan will provide ample information in this regard. 3 In cases were the relevant anatomy is not clear, an MRI test may also be done. This will allow the surgeon to better prepare for surgery (if necessary).
Why does urine go backwards?
This is because the ureterocele distorts the normal one-way valve between the ureter and bladder. Reflux into the opposite kidney may happen. There is also a small risk for kidney stones.
What is a VCUG test?
This is a series of X-rays of the bladder and lower urinary tract taken with a special dye. First a catheter is inserted in the urethra to fill the bladder with a water-based dye.
How many ureters are there in the human body?
Most of us are born with two ureters, one from each kidney to drain urine into the bladder. Some (1 in 125 people), on the other hand, have two ureters draining a kidney. This is called "duplex anomaly" of the kidney. A "duplex anomaly" can be associated with a variety of conditions that can affect the kidney health.
Where does urine go in the body?
Urine travels from the kidneys down narrow tubes called ureters. The ureters bring urine to the bladder, where it is then stored. There is a flap valve between the ureters and the bladder to keep urine flowing in only one direction.
How to diagnose ureterocele?
A ureterocele is most commonly diagnosed by ultrasound. An ultrasound is very good at detecting dilation (hydronephrosis) of the kidney and ureter that can be seen with ureteroceles as well as detecting the ureterocele itself in the bladder. Other tests are often performed when a ureterocele is diagnosed.
What is a duplex kidney?
If the ureterocele is associated with a duplex kidney, it is the ureter that drains the upper part of the kidney that has the uretero cele. Kidneys that have a ureterocele often are dilated and can have obstruction to urine flow.
Can a baby have a urinary tract infection?
Rarely, infants present with a very severe urinary tract infection that has spread to the blood stream and they require urgent drainage of the infected urine behind the ureterocele (see treatment below).
How common is ureteroceles?
Ureteroceles are known to happen roughly in 1 in 4000 children, being most common in Caucasians [ 1, 3 ].They are more frequently seen in females (almost 4 times as compared to males).This ratio holds true from pediatric age to adult age ranges [ 1 - 4 ].
What is a ureter cyst?
A ureterocele is a cystic dilatation of the distal ureter with variance in anatomy and presenting symptoms. Ureteroceles can be associated with single or duplex collecting systems. The clinical presentation can be so diverse as to be ranging from totally asymptomatic to overt urinary tract infection. It is multimodal management when it comes ...
What is a vcug?
Voiding cystourethrogram (VCUG) facilitates in detecting the ureterocele, it also helps in detecting the grade of vesicoureteral reflux (VUR) if present. VCUG is a useful investigation that facilitates not only to diagnose VUR but it also detects any new reflux that may come up post endoscopic treatment.
Is ureterocele a duplex?
Ureteroceles can be associated with single or duplex collecting systems. Additionally, it may be either intravesical (orthotopic) or open at extravesical site (ectopic ureterocele) [ 2 ]. Naturally. Vesicoureteric Reflux (VUR) may be the result and can be present in the upper moiety or both of the moieties.
ORIGINAL RESEARCH article
Front. Pediatr., 08 April 2019 | https://doi.org/10.3389/fped.2019.00106
Introduction
Ureterocele (UTC), often associated with complete duplicated collecting system, represents uncommon cause of congenital uretero-vesical obstruction, present from early prenatal age. It can produce severe consequences on renal parenchyma and urinary tract in infants and young children ( 1, 2 ).
Patients and Methods
The research design was conducted as retrospective study during the last 6 years, from January 2012 to December 2017, at the Division of Pediatric Urology of the “Bambino Gesù” Children's Hospital. The Institutional Ethical Committee approved the study.
Results
From January 2012 to December 2017, a total of 69 children presenting obstructive UTC was treated endoscopically by laser multiple punctures. Three patients were lost to follow-up and two had UTC prolapsing outside the external meatus and were excluded.
Discussion
UTC is usually defined as a cystic dilatation of the terminal portion of the ureter inside the bladder basis ( 1, 2 ). Depending to the position on the bladder, UTCs are classified as orthotopic or intravesical and ectopic or extravesical.
Conclusions
The endoscopic technique of multiple punctures at the UTC basis utilizing Holmium laser as energy has been demonstrated as very effective and simple procedure, with short hospital stay, to decompress congenital obstructing UTC in newborns, infants, and children.
Author Contributions
All authors contributed actively to the study. PC and SGN conceptualized the design of the study. MB, GC, EMa, and MI performed retrospective patients chart review. EMe and NC interpreted data and reviewed literature. PC and NC drafted the manuscript. All authors read, revised, and approved the final manuscript.
Abstract
Ureterocele is due to a developmental abnormality followed by distension of the “floor” of the intramural ureter but it can not be considered as a single entity.
Keywords
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
About this chapter
Küss R., Chatelain C. (1975) Surgery of Ureterocele. In: Surgery of the Ureter. Handbuch der Urologie / Encyclopedia of Urology, vol 13 / 3. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-66079-5_12
