Abstract
Purpose We assessed outcomes in children with ureterocele after transurethral incision at our institution between 2001 and 2014, focusing on end points of vesicoureteral reflux, improvement of hydronephrosis and need for second surgery. Materials and Methods We performed chart reviews of 83 patients, collecting information including age at transurethral incision, gender, renal anatomy, ureterocele location, indication for transurethral incision, and preincision and postincision vesicoureteral reflux and hydronephrosis status. Patients were divided into those with single system and duplex system ureteroceles, and intravesical and extravesical location for analysis. Statistical evaluations were performed with the Wilcoxon rank test and Fisher exact test. Results Transurethral incision was performed at a mean age of 34.2 months in patients with single system ureterocele and 8.9 months in those with duplex system ureterocele (p <0.0001). Cure rates (improvement of hydronephrosis and absence of vesicoureteral reflux) were 55.6% in patients with single system ureterocele and 14.9% in those with duplex system ureterocele (p = 0.0031). Rates of de novo reflux into the ureterocele moiety were 27.8% for patients with single system ureterocele and 56.2% for those with duplex system ureterocele (p = 0.0773). Patients with single system ureterocele required significantly fewer second surgeries (3.8%) than those with duplex system ureterocele (73.7%, p <0.0001). Conclusions Patients with single system ureterocele may benefit from endoscopic incision. Transurethral incision was definitive in all such patients except 1 in our study. Although most patients with duplex system ureterocele will need a second operation, transurethral incision remains of value in this population in instances of sepsis or bladder outlet obstruction, or to facilitate planned reconstruction when the child is older.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 662-666 |
| Number of pages | 5 |
| Journal | Journal of Urology |
| Volume | 193 |
| Issue number | 2 |
| DOIs | |
| State | Published - Jan 1 2015 |
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Keywords
- endoscopy
- kidney diseases
- patient outcome assessment
- ureterocele
- urethra
ASJC Scopus subject areas
- Urology
Cite this
Outcomes of endoscopic incision for the treatment of ureterocele in children at a single institution. / Sander, James C.; Bilgutay, Aylin N.; Stanasel, Irina; Koh, Chester J.; Janzen, Nicolette; Gonzales, Edmond T.; Roth, David R.; Seth, Abhishek.
In: Journal of Urology, Vol. 193, No. 2, 01.01.2015, p. 662-666.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Outcomes of endoscopic incision for the treatment of ureterocele in children at a single institution
AU - Sander, James C.
AU - Bilgutay, Aylin N.
AU - Stanasel, Irina
AU - Koh, Chester J.
AU - Janzen, Nicolette
AU - Gonzales, Edmond T.
AU - Roth, David R.
AU - Seth, Abhishek
PY - 2015/1/1
Y1 - 2015/1/1
N2 - Purpose We assessed outcomes in children with ureterocele after transurethral incision at our institution between 2001 and 2014, focusing on end points of vesicoureteral reflux, improvement of hydronephrosis and need for second surgery. Materials and Methods We performed chart reviews of 83 patients, collecting information including age at transurethral incision, gender, renal anatomy, ureterocele location, indication for transurethral incision, and preincision and postincision vesicoureteral reflux and hydronephrosis status. Patients were divided into those with single system and duplex system ureteroceles, and intravesical and extravesical location for analysis. Statistical evaluations were performed with the Wilcoxon rank test and Fisher exact test. Results Transurethral incision was performed at a mean age of 34.2 months in patients with single system ureterocele and 8.9 months in those with duplex system ureterocele (p <0.0001). Cure rates (improvement of hydronephrosis and absence of vesicoureteral reflux) were 55.6% in patients with single system ureterocele and 14.9% in those with duplex system ureterocele (p = 0.0031). Rates of de novo reflux into the ureterocele moiety were 27.8% for patients with single system ureterocele and 56.2% for those with duplex system ureterocele (p = 0.0773). Patients with single system ureterocele required significantly fewer second surgeries (3.8%) than those with duplex system ureterocele (73.7%, p <0.0001). Conclusions Patients with single system ureterocele may benefit from endoscopic incision. Transurethral incision was definitive in all such patients except 1 in our study. Although most patients with duplex system ureterocele will need a second operation, transurethral incision remains of value in this population in instances of sepsis or bladder outlet obstruction, or to facilitate planned reconstruction when the child is older.
AB - Purpose We assessed outcomes in children with ureterocele after transurethral incision at our institution between 2001 and 2014, focusing on end points of vesicoureteral reflux, improvement of hydronephrosis and need for second surgery. Materials and Methods We performed chart reviews of 83 patients, collecting information including age at transurethral incision, gender, renal anatomy, ureterocele location, indication for transurethral incision, and preincision and postincision vesicoureteral reflux and hydronephrosis status. Patients were divided into those with single system and duplex system ureteroceles, and intravesical and extravesical location for analysis. Statistical evaluations were performed with the Wilcoxon rank test and Fisher exact test. Results Transurethral incision was performed at a mean age of 34.2 months in patients with single system ureterocele and 8.9 months in those with duplex system ureterocele (p <0.0001). Cure rates (improvement of hydronephrosis and absence of vesicoureteral reflux) were 55.6% in patients with single system ureterocele and 14.9% in those with duplex system ureterocele (p = 0.0031). Rates of de novo reflux into the ureterocele moiety were 27.8% for patients with single system ureterocele and 56.2% for those with duplex system ureterocele (p = 0.0773). Patients with single system ureterocele required significantly fewer second surgeries (3.8%) than those with duplex system ureterocele (73.7%, p <0.0001). Conclusions Patients with single system ureterocele may benefit from endoscopic incision. Transurethral incision was definitive in all such patients except 1 in our study. Although most patients with duplex system ureterocele will need a second operation, transurethral incision remains of value in this population in instances of sepsis or bladder outlet obstruction, or to facilitate planned reconstruction when the child is older.
KW - endoscopy
KW - kidney diseases
KW - patient outcome assessment
KW - ureterocele
KW - urethra
UR - http://www.scopus.com/inward/record.url?scp=84920725983&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84920725983&partnerID=8YFLogxK
U2 - 10.1016/j.juro.2014.08.095
DO - 10.1016/j.juro.2014.08.095
M3 - Article
C2 - 25167992
AN - SCOPUS:84920725983
VL - 193
SP - 662
EP - 666
JO - Journal of Urology
JF - Journal of Urology
SN - 0022-5347
IS - 2
ER -