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Pediatric Ureteroceles: Diagnosis, Management and Treatment Options

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Author(s): Cüneyt Günşar | Erol Mir | Aydın Şencan | Pelin Ertan | Cansu Ünden Özcan

Journal: Iranian Journal of Pediatrics
ISSN 2008-2142

Volume: 20;
Issue: 4;
Start page: 413;
Date: 2010;
Original page

Keywords: Ureterocele | Hydronephrosis | Vesicoureteral reflux | Voiding Cystourethrography | Ultrasound

ABSTRACT
Objective: The aim of the study was to evaluate clinical characteristics of ureteroceles particularly for diagnostic and treatment challenges. Methods: Data about patients treated for ureterocele in the two hospital clinics during 1996- 2009 are retrospectively evaluated. Findings: There were 12 girls and 7 boys. Symptomatic urinary tract infection was found in twelve cases. Ureterocele was associated with duplex systems in eleven cases. Vesicoureteral reflux was detected in 4 patients. Bladder diverticulum complicated with ureterocele in 1 patient. Ultrasonography diagnosed ureterocele in 12 patients. Renal scarring was detected in 6 patients at the side of ureterocele. Fifteen patients showed varying degrees of hydro-ureteronephrosis. Surgical therapy included upper pole nephrectomy in 3 cases. Bladder level reconstruction was performed in 11 cases. Five patients were treated only by endoscopic incision. In the follow up period 4 patients showed long term urinary tract infections whereas 3 of them were treated endoscopically. Postoperative reflux was still present in two patients who were treated by endoscopic incision. Conclusion: Ureterocele diagnosis and treatment show challenges. Urinary tract infection is important marker for urinary system evaluation. Preoperative management generally depends on a combination of diagnostic methods. Endoscopic incision needs serious follow up for postoperative problems.

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