Management of duplex-system ureterocele

Authors

  • Bhanu Mariyappa,

    Corresponding author
    1. Department of Paediatric Surgery, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
    • Correspondence: Dr Bhanu Mariyappa, Department of Paediatric Surgery, Princess Margaret Hospital, Roberts Road, Subiaco, Perth, WA 6008, Austrailia. Fax: +61 89340 8693; email: tvkbhanu@yahoo.com

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  • Andrew Barker,

    1. Department of Paediatric Surgery, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
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  • Naeem Samnakay,

    1. Department of Paediatric Surgery, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
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  • Japinder Khosa

    1. Department of Paediatric Surgery, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
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  • Conflict of interest: None declared.

Abstract

Aim

To analyse different treatment modalities, functional outcome and continence in children treated for duplex-system ureterocele and to review the relevant literature.

Methods

The medical records of patients with duplex-system ureterocele treated between 2001 and 2011 were reviewed retrospectively.

Results

Twenty-two cases were identified. Five patients underwent incision of the ureterocele as initial procedure. It was curative in only one patient. Seven patients underwent upper-pole nephroureterectomy. It was curative in 4 cases. Five patients underwent excision of ureterocele and common-sheath reimplant, and the remaining 5 patients had upper-pole nephroureterectomy and simultaneous excision of ureterocele with lower-moiety ureteric reimplantation. These surgeries were curative in all patients. Follow-up ranged from 4 to 84 months. Functional outcome was good in all patients. Fourteen patients were continent at follow-up, and continence was not assessed in the other 8 because of young age.

Conclusions

Our data suggest a higher rate of secondary procedures if there is retained ureterocele. Data also suggest that complete reconstruction can be safely performed in a young infant without any adverse effect on continence.

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