title: Does the endoscopic technique of ureterocele incision matter?
abstract: OBJECTIVE
  Endoscopic ureterocele decompression is a well established procedure in children. However, an accurate endoscopic incision may be challenging in large ectopic ureteroceles. We describe a percutaneously assisted technique to facilitate the ease of ureterocele incision and review other described methods.
  
  
  METHODS
  We reviewed the medical records of 12 children with ectopic ureteroceles subtending a double collecting system who underwent endoscopic, percutaneously assisted incision. Six ureteroceles were on the left side, 5 were on the right side and 1 child had bilateral ureteroceles. Decompression results were evaluated by ultrasound and Tc-mercaptoacetyltriglycine imaging during a mean of 2.8 years of followup.
  
  
  RESULTS
  There were 7 girls and 5 boys. Mean age at presentation was 11.6 months (range 1 week to 6 years). The decompression success rate was 84% (11 of 13 renal units), and improved renal function and drainage was noted in 5 of 12 patients (41.6%). Seven of 12 patients had vesicoureteral reflux, of whom 2 were asymptomatic at followup and, hence, were treated conservatively. Five children underwent surgery because of recurrent urinary tract infections.
  
  
  CONCLUSIONS
  Although our results are similar to those of other methods, percutaneously assisted cystoscopic incision of ureterocele enables easier and more accurate decompression. However, when comparing the various techniques described, it seems that postoperative results mostly reflect the anatomical and functional characteristics of the urinary system rather than the technique used.
authors.affiliation: Paediatric Urology Unit, Sunshine Hospital, Parkville, Victoria, Australia.
authors.forename: D
authors.initials: D
authors.lastname: Ben Meir
authors.forename: C J T D A E
authors.initials: CJ
authors.lastname: Silva
authors.forename: P
authors.initials: P
authors.lastname: Rao
authors.forename: D
authors.initials: D
authors.lastname: Chiang
authors.forename: P A
authors.initials: PA
authors.lastname: Dewan
mesh_terms: D002648:Child; D002675:Child, Preschool; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D014518:Ureterocele / Q000601:surgery*; D018666:Ureteroscopy / Q000379:methods*