[Treatment of pyeloureteral duplication associated with ureterocele or ectopic ureter].
BACKGROUND
Pyeloureteral duplication is often associated to ureterocele and ectopic ureter. Therapeutic approach of ureterocele is actually a debated subject because of the differences treatments. There is controversy about the classic heminefrectomy with ureterocele aspiration and the minimal invasive endoscopic approach.


METHODS
We made a retrospective study about 34 children with pyeloureteral duplication associated with ureterocele (26) or with ectopic ureter (8). The election of treatment was mainly based on renal function, showed on gammagraphy. It was performed heminephrectomy and ureterocele aspiration in patients with hypofunctioning upperpole, and surgery saving the kidney when the renal function was normal.


RESULTS
Heminephrectomy was curative in 66.5% of children with ureterocele. In the others was required a correction of the vesicoureteral reflux associated with the lower pole or removal of the ureterocele with ureteral reimplantation due to failure in ureterocele collapse. 88.5% of ureterocele was collapsed. None of the heminefrectomies performed on patients with ectopic ureter needed further surgery. Pathology studies showed a high incidence of renal dysplasia (63%).


CONCLUSIONS
We consider the heminephrectomy the treatment of choice in pyeloureteral duplication associated with ureterocele and ectopic ureter when gammagraphy studies show hypofunctioning upperpole.
Somoza Argibay
I
I
Servicio de Cirugía Pediátrica, Hospital Materno Infantil Teresa Herrera, Complejo Hospitalario Juan Canalejo, A Coruña.
Méndez Gallart
R
R
Gómez Tellado
M
M
Pais Piñeiro
E
E
Liras Muñoz
J
J
Vázquez Martull
E
E
Vela Nieto
D
D
D000015:Abnormalities, Multiple / Q000628:therapy*; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007682:Kidney Pelvis / Q000002:abnormalities*; D008297:Male; D012189:Retrospective Studies; D014513:Ureter / Q000002:abnormalities*; D014518:Ureterocele / Q000150:complications*