Journal article
LONG-TERM FOLLOWUP OF ENDOSCOPIC INCISION OF URETEROCELES: INTRAVESICAL VERSUS EXTRAVESICAL
The Journal of urology, Vol.164(3 Part 2), pp.1097-1100
09/2000
DOI: 10.1016/S0022-5347(05)67261-8
PMID: 10958751
Abstract
Purpose: Endoscopic incision was performed as the initial therapy for ureteroceles in children presenting to our institutions between 1985 and 1990. To assess the long-term efficacy of this treatment modality we reevaluated the outcome of these patients. Materials and Methods: Parameters reviewed included patient age at surgery, position of the ureterocele, a duplex system, preoperative and postoperative reflux, and the need for additional operations. Statistical analysis consisted of chi-square and Wilcoxon's rank sum tests. Results: Of the patients 22 had intravesical and 22 had extravesical ureteroceles. Average age at initial surgery was 1.9 ± 3.7 years with average followup of 7.2 ± 3.1 years. A second operation was required in 18 cases (41%), which was significantly more likely for an extravesical ureterocele (18% versus 64%, p = 0.002), a duplex system (p = 0.026) or preoperative reflux (p = 0.02). Second operations included reimplantation in 13 cases, upper pole partial nephrectomy in 7, total nephroureterectomy in 3, bladder neck reconstruction in 3 and lower pole pyeloplasty in 3. The only secondary operations performed for intravesical ureteroceles were reimplantation in 3 cases and upper pole nephrectomy in 1. New onset reflux developed in 14 of 27 patients (52%) postoperatively, including 7 with intravesical and 7 with extravesical ureteroceles. None required a second open operation. Conclusions: With extended followup the percentage of patients requiring open surgery after endoscopic incision of ureteroceles increased from our original report of 27% to 41% (p = 0.166). Only 18% of cases with an intravesical ureterocele required a subsequent operation compared to 64% with an extravesical ureterocele (p = 0.002). The reduction in size of the obstructed ureter following endoscopic decompression facilitated successful reimplantation. Endoscopic puncture permits definitive treatment in the majority of children by at most a single incision, open operation at the bladder level.
Details
- Title: Subtitle
- LONG-TERM FOLLOWUP OF ENDOSCOPIC INCISION OF URETEROCELES: INTRAVESICAL VERSUS EXTRAVESICAL
- Creators
- CHRISTOPHER S. Cooper - Children's Hospital of PhiladelphiaGIACOMO PASSERINI-GLAZEL - Children's Hospital of PhiladelphiaJOEL C. Hutcheson - Children's Hospital of PhiladelphiaMASSIMO Iafrate - Children's Hospital of PhiladelphiaCRISTINA Camuffo - Children's Hospital of PhiladelphiaCLAUDIO Milani - Children's Hospital of PhiladelphiaHOWARD M. Snyder - Children's Hospital of Philadelphia
- Resource Type
- Journal article
- Publication Details
- The Journal of urology, Vol.164(3 Part 2), pp.1097-1100
- DOI
- 10.1016/S0022-5347(05)67261-8
- PMID
- 10958751
- ISSN
- 0022-5347
- eISSN
- 1527-3792
- Language
- English
- Date published
- 09/2000
- Academic Unit
- Stead Family Department of Pediatrics; Urology; Medicine Administration
- Record Identifier
- 9984319990602771
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