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Proceedings of the Royal Society of... Jul 1963
Topics: Humans; Ureter; Ureterocele
PubMed: 14017039
DOI: No ID Found -
Proceedings of the Royal Society of... Sep 1958
Topics: Disease; Humans; Ureter; Ureteral Diseases; Ureterocele
PubMed: 13591306
DOI: No ID Found -
Frontiers in Pediatrics 2021A 14-year-old girl noticed malodorous urine and experienced left flank pain. The patient was presented to our hospital with gradually increasing pain. She had no...
A 14-year-old girl noticed malodorous urine and experienced left flank pain. The patient was presented to our hospital with gradually increasing pain. She had no underlying disease but had a history of pain on micturition for several days. Hematologic examination indicated low white blood cell and platelet counts and a high serum lactate level. Computed tomography showed that a part of the parenchyma of the left kidney had poor contrast and was deteriorated, with fluid and gas retention from the perirenal region to the retroperitoneal cavity. A left hydroureter and large ureterocele were observed in the bladder. She was diagnosed with emphysematous pyelonephritis (EPN) with a giant congenital ureterocele. Vasopressors and blood transfusion failed to maintain normal circulatory dynamics, and an open left nephrectomy and transurethral ureterocele fenestration were performed. The excised outer portion of the left kidney was dissolved by the infection and replaced with blood clots and necrotic tissue. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry identified the inflammatory, gas-producing bacteria , and . Meropenem was administered for 4 days postoperatively and then de-escalated to sulbactam/ampicillin for another 10 days. The patient was discharged on day 17 of hospitalization, and the postoperative course remained favorable. EPN is extremely rare in pediatric patients, and it is believed that nephrectomy is sometimes necessary if the patient does not have normal circulatory dynamics despite the use of catecholamines.
PubMed: 34900875
DOI: 10.3389/fped.2021.775468 -
International Urology and Nephrology Oct 2023The aims of this study were to analyze the clinical outcomes of treating duplex system ureteroceles with early endoscopic puncture decompression and to identify the risk...
Clinical outcomes and risk factor analysis of early endoscopic puncture decompression for ureterocele associated with duplex kidney in children: a single-center retrospective study.
PURPOSE
The aims of this study were to analyze the clinical outcomes of treating duplex system ureteroceles with early endoscopic puncture decompression and to identify the risk factors related to outcomes to help guide future work.
MATERIALS AND METHODS
We retrospectively reviewed the clinical records of patients with ureteroceles with duplex kidney that were treated with early endoscopic puncture decompression. Charts were reviewed for demographics, preoperative imaging, surgical indications, and follow-up data. Recurrent febrile urinary tract infections (fUTIs), de novo vesicoureteral reflux (VUR), persistent high-grade VUR, unrelieved hydroureteronephrosis, and the need for further intervention were considered unfavorable outcomes. Gender, age at surgery, BMI, antenatal diagnosis, fUTIs, bladder outlet obstruction (BOO), type of ureterocele, ipsilateral VUR diagnosed before surgery, simultaneously upper-pole moiety (UM) and lower-pole moiety (LM) obstruction, the width of ureter affiliated to UM, and maximum diameter of ureterocele were all considered potential risk factors. A binary logistic regression model was used to identify the risk factors of unfavorable outcomes.
RESULTS
A total of 36 patients with ureteroceles related to duplex kidney underwent endoscopic holmium laser puncture from 2015 to 2023 at our institution. After a median follow-up of 21.6 months, unfavorable outcomes developed in 17 patients (47.2%). Three patients underwent ipsilateral common-sheath ureter reimplantation and one patient underwent laparoscopic ipsilateral upper to lower ureteroureterostomy combined with recipient ureter reimplantation. Three patients underwent laparoscopic upper-pole nephrectomy. Fifteen patients suffered from recurrent UTIs were treated with oral antibiotics and eight of them were diagnosed de novo VUR according to voiding cystourethrography (VCUG). In univariate analysis, patients with simultaneously UM and LM obstruction (P = 0.003), fUTIs before surgery (P = 0.044), and ectopic ureterocele (P = 0.031) were more likely to have unfavorable outcomes. Binary logistic regression analysis showed that ectopic ureterocele (OR = 10.793, 95% CI 1.248-93.312, P = 0.031) and simultaneously UM and LM obstruction (OR = 8.304, 95% CI 1.311-52.589, P = 0.025) were identified as independent factors for unfavorable outcomes.
CONCLUSIONS
Our study suggested that early endoscopic puncture decompression is not a preferred but an available treatment option to release BOO or to cure refractory UTIs. It was easier to fail if the ureterocele was ectopic or simultaneously UM and LM obstruction existed. Gender, age at surgery, BMI, antenatal diagnosis, fUTIs, bladder outlet obstruction (BOO), ipsilateral VUR diagnosed before surgery, the width of ureter affiliated to UM, and maximum diameter of ureterocele were not significantly related to the success rate of early endoscopic punctures.
Topics: Child; Humans; Female; Pregnancy; Infant; Ureterocele; Retrospective Studies; Urinary Bladder Neck Obstruction; Kidney Diseases; Kidney; Vesico-Ureteral Reflux; Urinary Tract Infections; Risk Factors; Punctures; Laparoscopy; Decompression; Treatment Outcome
PubMed: 37393384
DOI: 10.1007/s11255-023-03694-y -
The Pan African Medical Journal 2021Ureterocele is a pseudo-cyst dilation of the terminal submucosal ureter. It is a rare malformative uropathy, in particular associated with simplex ureter. We conducted a...
Ureterocele is a pseudo-cyst dilation of the terminal submucosal ureter. It is a rare malformative uropathy, in particular associated with simplex ureter. We conducted a retrospective study over a period of 10 years. Twelve medical records of patients whose data were collected at the Department of Paediatric Surgery of Monastir between 2006 and 2016 were examined. The average age of patients was 2.7 years (ranging from 7 days to 11 years) with a sex ratio of 1. Patients´ clinical status was dominated by fever due to upper urinary tract infection. Diagnosis was mainly based on renal bladder ultrasound, intravenous urography (IVU) and retrograde urethrography and cystography. Ureterocele was unilateral in 10 cases and bilateral in 2 cases (on a total of 14 cases). It was associated with simplex ureter in all cases and all patients underwent endoscopic surgery. No perioperative adverse event was reported. The postoperative course was uneventful. Clinical and radiological improvements were reported in all cases. Ureterocele associated with simplex ureter is a very rare urinary abnormality. Early diagnosis is essential to avoid upper urinary tract involvement. Endoscopic treatment is a good alternative leading to satisfactory results.
Topics: Child; Child, Preschool; Cystography; Endoscopy; Female; Fever; Humans; Infant; Infant, Newborn; Male; Retrospective Studies; Ureter; Ureterocele; Urinary Bladder; Urinary Tract Infections; Urography
PubMed: 34367424
DOI: 10.11604/pamj.2021.38.345.15142 -
BMJ Case Reports Jun 2021We present a unique case of bladder leiomyoma that was mistakenly diagnosed as a ureterocele. The delay in diagnosis meant ongoing significant voiding lower urinary...
We present a unique case of bladder leiomyoma that was mistakenly diagnosed as a ureterocele. The delay in diagnosis meant ongoing significant voiding lower urinary tract symptoms, which could have been avoided. This was eventually successfully treated by transurethral resection. Leiomyoma is the most common benign bladder mass and should be considered in the differential diagnosis when a smooth mass with normal overlying mucosa is seen on cystoscopy or a homogeneous, low density bladder mass is seen on cross-sectional imaging. Despite the benign nature of the lesion, leiomyoma can convey significant morbidity to the patient.
Topics: Cystoscopy; Humans; Leiomyoma; Ureterocele; Urinary Bladder Neoplasms
PubMed: 34130981
DOI: 10.1136/bcr-2021-242866 -
Turkish Journal of Urology Dec 2017Ureteroceles are a great clinical challenge because of variations in anatomy and clinical presentations. We present our experience with primary transurethral incision of...
OBJECTIVE
Ureteroceles are a great clinical challenge because of variations in anatomy and clinical presentations. We present our experience with primary transurethral incision of ureteroceles in children.
MATERIAL AND METHODS
Data of thirteen children managed for ureterocele from 2009 to 2016 was retrospectively analyzed with respect to age, sex, clinical presentation and symptomatology, type and localization of ureterocele, investigations, surgical management and follow-up.
RESULTS
A total of 13 patients with ureteroceles were managed. There were 7 males and 6 females. Six were neonates with antenatal diagnosis of ureteroceles. Five patients presented with urinary tract infection and two were diagnosed during ultrasound for abdominal pain. The ureteroceles were on the right side in 7 patients and left in 6 patients. Six patients had a duplex system-five on right side and bilateral in one. Two patients had ureteroceles in solitary kidney. Four patients had associated hydronephrosis and hydroureter and two had only hydronephrosis alone. One patient had bilateral grade III reflux in the bilateral lower moieties of the patient with bilateral duplex system. Two patients had poorly functioning kidney on radionuclide scan. All patients underwent cystoscopic incision of the ureteroceles. Eleven had intravesical ureteroceles and two had large caeco-ureteroceles. Two patients required ureteric reimplantation during follow-up.
CONCLUSION
Though the approach of managing a patient with ureterocele should be individualized, transurethral incision remains valuable as a primary intervention with regular follow up. It may even prove to be the only intervention required in most of the patients.
PubMed: 29201520
DOI: 10.5152/tud.2017.57514 -
Anales de Pediatria (Barcelona, Spain :... Oct 2012Review the clinical and radiological characteristics of the different kinds of urinary tract duplications, assessing the outcome of the cases and the incidence of renal...
OBJECTIVES
Review the clinical and radiological characteristics of the different kinds of urinary tract duplications, assessing the outcome of the cases and the incidence of renal parenchymal injury.
MATERIAL AND METHODS
A retrospective study was performed including 301 children diagnosed of renal duplication by urological ultrasound, voiding cystourethrogram (VCUG) and 99-technetium renal scintigraphy (DMSA).
RESULTS
They were classified in four groups. The first consisted of 166 (55.1%) cases that had complete ureteral duplication without an obstructive component (CD). The cases that had an upper system obstruction due to an ectopic ureter (EU), 19 (6.3%), or an ureterocele (UTC), 35 (11.6%), were divided into two different groups. The fourth group 81 (26.9%) had incomplete ureteral duplication. The nephro-urological study was performed in 181/301 after a urinary tract infection; in 100/301 after a prenatal finding of hydronephrosis. It was a casual diagnosis in 20/301. The percentage upper kidney dilation in the diagnostic ultrasound was significantly higher in those with EU 16/19 (84%) and in those with UTC 33/35 (94%), compared with the upper pole dilations found in the CD 35/166 (21%) and ID 21/81 (25%). Surgery was performed in 96/166 (41%) of the CD, 7/81 of the ID, 16/19 (84%) of the EU, and 34/35 (97%) of the UTC. Three cases with EU and 8 with UTC needed a second surgery, and 3 a third one. No scintigraphy changes were observed in 58% of the patients in the CD group, 87% in the ID group, 29% in the EU group, and 5% in the UTC group. As regards the renal duplications who did not have surgery, it was found that there were 98 refluxing units in the CD, and 74 in the ID. The spontaneous resolution of the vesicoureteral reflux (VUR) was 80% in the CD, and 90% in the ID (McNemar test P<.001). The average healing time ranged from 1 year to 5 years (Mean: 3 years and 3 months).
CONCLUSION
The patients with higher risk of having renal injury are those who presented with a duplication with upper kidney obstruction due to ectopic insertion of the ureter, particularly due to an ureterocele.
Topics: Child, Preschool; Choristoma; Female; Humans; Hydronephrosis; Infant; Kidney; Kidney Diseases; Male; Retrospective Studies; Ureter; Ureteral Obstruction; Ureterocele
PubMed: 22534038
DOI: 10.1016/j.anpedi.2012.03.006 -
Proceedings of the Royal Society of... 1922
PubMed: 19982643
DOI: No ID Found -
International Braz J Urol : Official... 2020Pediatric ureteroceles have a cited incidence at autopsy between 1 in 4000 and 1 in 500. In some cases, a calculus may be associated with the ureterocele. This case...
INTRODUCTION
Pediatric ureteroceles have a cited incidence at autopsy between 1 in 4000 and 1 in 500. In some cases, a calculus may be associated with the ureterocele. This case presentation and surgical video highlights successful management of an intravesical ureterocele and calculus using an open approach.
PATIENT AND METHOD
A 12 year old male presented to our clinic with irritative LUTS, incomplete emptying, and intermittent incontinence. A urinalysis was positive for blood and follow-up renal ultrasound revealed a 3cm ureterocele with a 1.5cm diameter calculus. Using an open, transabdominal approach, the ureterocele was incised and the calculus was removed. The ureterocele sac was excised at its junction with the bladder, and the distal ureter was released. In a Cohen cross-trigonal approach, a ureteroneocystostomy was then completed.
RESULTS
Our patient tolerated surgery well, and was discharged on post-operative day one. Bladder ultrasound at three months revealed resolution of the ureterocele.
CONCLUSION
With a post-operative course comparable to robotic surgery, open ureterocelectomy is an important approach that may be utilized in management of complex ureteroceles.
PubMed: 32822146
DOI: 10.1590/S1677-5538.IBJU.2019.0301