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• W2000620750 abstract "No AccessJournal of UrologyPEDIATRIC UROLOGY1 Apr 2001OUTCOME OF PATIENTS WITH PRENATALLY DETECTED DUPLEX SYSTEM URETEROCELE; NATURAL HISTORY OF THOSE MANAGED EXPECTANTLY K.R. SHANKAR, N. VISHWANATH, and A.M.K. RICKWOOD K.R. SHANKARK.R. SHANKAR More articles by this author , N. VISHWANATHN. VISHWANATH More articles by this author , and A.M.K. RICKWOODA.M.K. RICKWOOD More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)66494-4AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We assessed the outcome of patients treated for prenatally detected duplex system ureterocele with particular reference to those treated expectantly. Materials and Methods: We reviewed the records of 52 consecutive patients treated between 1984 and 1999 with a median followup of 8 years (range 1 to 16.2). Results: Of the 38 patients who underwent surgical treatment 13 subsequently required unplanned secondary procedures. A total of 14 cases satisfying currently defined criteria, including less than 10% upper renal pole function, an unobstructed lower pole (absent nonrefluxing hydroureteronephrosis), lower pole vesicoureteral reflux not exceeding grade III and unobstructed bladder outflow, were managed expectantly with a median followup of 8 years (range 1.6 to 12.8). In this group of patients prophylactic antibiotics were routinely prescribed until the completion of toilet training or age 5 years in those with persistent reflux on repeat cystography. None has required surgery or had symptoms or urinary infection. In 6 cases followup ultrasonography showed substantial resolution of upper pole hydronephrosis with a collapsed ureterocele. Furthermore, 7 of the 38 patients who underwent surgical treatment early in our series would have been treated expectantly had the current criteria been applied. Conclusions: In 14 of the 52 patients (approximately 27%) with prenatally detected duplex system ureterocele the natural history of the complaint is essentially benign within the currently available followup. References 1 : Surgical correction of ureterocele in childhood. J Pediatr Surg1971; 6: 235. Google Scholar 2 : Duplex ureterocele(s): is radical surgery always necessary?. Eur J Pediatr Surg1994; 4: 207. Google Scholar 3 : The role of minimal surgery with renal preservation in abnormal complete duplex systems. Pediatr Surg Int1999; 15: 347. Google Scholar 4 : Management of ectopic ureterocele associated with renal duplication: a comparison of partial nephrectomy and endoscopic decompression. J Urol1999; 162: 1406. Link, Google Scholar 5 : The modern endoscopic approach to ureterocele. J Urol2000; 163: 940. Link, Google Scholar 6 : Current management of duplex-system ureteroceles: experience with 41 patients. Br J Urol1992; 70: 196. Crossref, Medline, Google Scholar 7 : Experience with duplex system anomalies detected by prenatal ultrasonography. J Urol1993; 149: 808. Link, Google Scholar 8 : Long-term outcome of transurethral puncture of ectopic ureteroceles: initial success and late problems. J Urol1999; 162: 1077. Link, Google Scholar 9 : Does the endoscopic incision of ureterocele reduce the indications for partial nephrectomy?. BJU Int1999; 83: 675. Google Scholar 10 : Endoscopic incision of ureteroceles: intravesical versus ectopic. J Urol1993; 149: 556. Link, Google Scholar 11 : Editorial: individualized approach to the prenatally diagnosed ureterocele. J Urol1998; 159: 1011. Link, Google Scholar 12 : Ureterocele associated with ureteral duplication and a non-functioning upper polar segment: management by partial nephrectomy alone. J Urol1995; 154: 723. Link, Google Scholar 13 : Incidence of urinary tract infection in neonates with antenatal diagnosed ureteroceles. Eur J Pediatr Surg2000; 10: 111. Google Scholar From the Department of Paediatric Urology, Alder Hey Children’s Hospital, Liverpool, England© 2001 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byMerguerian P, Taenzer A, Knoerlein K, McQuiston L and Herz D (2010) Variation in Management of Duplex System Intravesical Ureteroceles: A Survey of Pediatric UrologistsJournal of Urology, VOL. 184, NO. 4S, (1625-1630), Online publication date: 1-Oct-2010.Byun E and Merguerian P (2018) A Meta-Analysis of Surgical Practice Patterns in the Endoscopic Management of UreterocelesJournal of Urology, VOL. 176, NO. 4S, (1871-1877), Online publication date: 1-Oct-2006.Direnna T and Leonard M (2018) Watchful Waiting for Prenatally Detected UreterocelesJournal of Urology, VOL. 175, NO. 4, (1493-1495), Online publication date: 1-Apr-2006.HAN M, GIBBONS M, BELMAN A, POHL H, MAJD M and RUSHTON H (2018) INDICATIONS FOR NONOPERATIVE MANAGEMENT OF URETEROCELESJournal of Urology, VOL. 174, NO. 4 Part 2, (1652-1656), Online publication date: 1-Oct-2005.CHERTIN B, RABINOWITZ R, POLLACK A, KOULIKOV D, FRIDMANS A, HADAS-HALPERN I and FARKAS A (2018) DOES PRENATAL DIAGNOSIS INFLUENCE THE MORBIDITY ASSOCIATED WITH LEFT IN SITU NONFUNCTIONING OR POORLY FUNCTIONING RENAL MOIETY AFTER ENDOSCOPIC PUNCTURE OF URETEROCELE?Journal of Urology, VOL. 173, NO. 4, (1349-1352), Online publication date: 1-Apr-2005.COPLEN D and AUSTIN P (2018) OUTCOME ANALYSIS OF PRENATALLY DETECTED URETEROCELES ASSOCIATED WITH MULTICYSTIC DYSPLASIAJournal of Urology, VOL. 172, NO. 4 Part 2, (1637-1639), Online publication date: 1-Oct-2004.DeFOOR W, MINEVICH E, TACKETT L, YASAR U, WACKSMAN J and SHELDON C (2018) Ectopic Ureterocele: Clinical Application of Classification Based on Renal Unit JeopardyJournal of Urology, VOL. 169, NO. 3, (1092-1094), Online publication date: 1-Mar-2003.UPADHYAY J, BOLDUC S, BRAGA L, FARHAT W, BÄGLI D, McLORIE G, KHOURY A and EL-GHONEIMI A (2018) Impact of Prenatal Diagnosis on the Morbidity Associated With Ureterocele ManagementJournal of Urology, VOL. 167, NO. 6, (2560-2565), Online publication date: 1-Jun-2002. Volume 165Issue 4April 2001Page: 1226-1228 Advertisement Copyright & Permissions© 2001 by American Urological Association, Inc.Keywordsultrasonography, prenatalkidneyabnormalitiesureteroceleureterMetricsAuthor Information K.R. SHANKAR More articles by this author N. VISHWANATH More articles by this author A.M.K. RICKWOOD More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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