Is an initial endoscopic treatment for all ureteroceles appropriate?
OBJECTIVE
A systematic initial endoscopic approach has been locally adopted since 2002 for the treatment of ureterocele. Our aim was to compare outcomes for patients treated with this approach to those treated prior to this date.


METHODS
We reviewed the charts of 145 children with ureteroceles treated surgically between 1992 and 2010. Patients were divided according to ureterocele position, year of treatment and type of initial intervention. Evaluation was completed by ultrasound, voiding cystourethrogram and nuclear renal scans.


RESULTS
Mean age at initial surgery was 18 months. Group 1 comprised 68 patients operated before 2002, and Group 2 66 patients operated after 2002. Group 1 patients showed a higher rate of preoperative vesicoureteral reflux. Mean follow-up was 43 and 25 months for group 1 and 2, respectively. Ureteroceles treated endoscopically underwent secondary procedures in 61% (group 1) and 42% (group 2) for ectopic and in 42% (group 1) and 10% (group 2) for orthotopic ureteroceles. Overall, there was more de novo upper moiety VUR in group 1 (48% vs 12%).


CONCLUSIONS
Primary endoscopic ureterocele treatment seems to be an appropriate option for children with a clinically significant ureterocele. The rate of secondary procedures was higher for ectopic ureteroceles but acceptable compared to the upper tract approach.
Division of Urology, Centre Hospitalier Universitaire de Québec, Université Laval, 2705 boulevard Laurier, R-1742, Québec, Canada. andreanne.boucher.1@ulaval.ca
Andréanne
A
Boucher
Jonathan
J
Cloutier
Alexandre
A
Rousseau
Roméo
R
Charrois
Stéphane
S
Bolduc
D004724:Endoscopy; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D014463:Ultrasonography; D014518:Ureterocele / Q000000981:diagnostic imaging / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*; D014718:Vesico-Ureteral Reflux