[Endoscopic treatment of prenatally diagnosed ureteroceles].
BACKGROUND
The authors report a series of 16 infants presenting with an antenatally diagnosed ureterocele, treated immediately, during the neonatal period, by endoscopic incision. The objective of this treatment is to ensure effective decompression of the ureterocele.


METHODS
The immediate postnatal assessment revealed 17 ureteroceles, including 7 intravesical ureteroceles (with one bilateral form) and 10 ectopic ureteroceles. Endoscopic opening allowed collapse of all of the ureteroceles and usually ensured improvement of renal function. Vesicoureteric reflux was observed secondarily in 7 infants with an ectopic form of the disease, and was present primarily in two other patients.


RESULTS
In patients with an intravesical form, endoscopic treatment was found to be effective on its own and no complementary procedure was required. In contrast, in ectopic forms, a second operation was required in 9 cases: presence of vesicoureteric reflux (8 cases) required resection of the ureterocele with vesical reconstruction and ureteric reimplantation according to Cohen's technique. In one case, total ureteronephrectomy was performed due to complete absence of function of the kidney concerned.


CONCLUSIONS
Endoscopic opening, performed soon after birth, can be considered to be the first-line treatment of antenatally diagnosed ureteroceles. Its main complication remains the secondary development of vesicoureteric reflux Radiological surveillance therefore appears to be essential.
Barret
E
E
Clinique chirurgicale infantile, Hôpital Charles Nicolle, Rouen, France.
Pfister
C
C
Dunet
F
F
Liard
A
A
Mitrofanoff
P
P
D004724:Endoscopy; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007668:Kidney / Q000503:physiopathology; D008297:Male; D009392:Nephrectomy; D011247:Pregnancy; D011859:Radiography; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal; D014513:Ureter / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D014518:Ureterocele / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D001743:Urinary Bladder / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D014718:Vesico-Ureteral Reflux / Q000209:etiology / Q000601:surgery