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• W2059403453 abstract "No AccessJournal of UrologyPediatric urology1 Dec 2006Endoscopic Treatment of Vesicovasal and Vesicoureteral Reflux in Infants With Persisting Mesonephric Duct Abdol-Mohammad Kajbafzadeh, and Seyedmehdi Payabvash Abdol-Mohammad KajbafzadehAbdol-Mohammad Kajbafzadeh More articles by this author , and Seyedmehdi PayabvashSeyedmehdi Payabvash More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2006.08.027AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We present a minimally invasive endoscopic approach for the treatment of persisting mesonephric duct in male infants. Materials and Methods: Five male infants 2 to 8 months old were referred with a history of recurrent sepsis, epididymo-orchitis and anorectal malformation that was treated elsewhere with initial colostomy. All infants had edematous unilateral testes, fever and poor feeding. Urine and blood cultures yielded the same microorganisms. All infections occurred while the infants were on regimens of prophylactic antibiotics. Comprehensive urological evaluations confirmed ipsilateral renal agenesis, sacral hypoplasia (3 patients), high anorectal malformation, and vesicovasal and vesicoureteral reflux. Results: All 5 infants underwent urethrocystoscopy under general anesthesia. The ectopic persisting mesonephric duct entered the bladder neck and proximal prostatic urethra. Injection of 0.4 to 0.7 ml Urocol®, used as a bulking agent, was administered submucosally at the opening of the persisting mesonephric duct. In 1 patient the orifice of the anomalous duct was not found during urethrocystoscopy, and ipsilateral vas ligation by titanium clips was performed. The results in the remaining 4 patients were excellent, and no further episodes of epididymitis were observed during a mean followup of 30 months. Conclusions: The diagnosis of persisting mesonephric duct should be considered in a male child with anorectal anomalies and recurrent epididymo-orchitis, and can be confirmed by radiological studies and cystoscopy. Endoscopic treatment of this anomaly should be considered first line therapy in these patients. However, surgical intervention is mandatory for children not responding to the procedure. References 1 : The persisting mesonephric duct syndrome: the description of a new syndrome. J Urol1983; 130: 958. Link, Google Scholar 2 : Ectopic vas deferens, imperforate anus and hypospadias: a new triad. J Urol1989; 141: 586. Link, Google Scholar 3 : The persisting mesonephric duct: high junction of vas deferens and ureter. J Urol1978; 120: 592. Link, Google Scholar 4 : Ectopia of the vas deferens. Pediatr Radiol1995; 25: 381. 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Link, Google Scholar 13 : Ectopic vas deferens communicating with lower ureter: embryological considerations. J Urol1972; 108: 172. Link, Google Scholar 14 : Congenital ectopic vas deferens inserting into the bladder with ipsilateral renal agenesis. Int Urol Nephrol1996; 28: 701. Google Scholar 15 : Bilateral vasal-ureteral communications. J Urol1976; 116: 808. Link, Google Scholar 16 : Partial obstruction, not antisperm antibodies, causing infertility after vasovasostomy. J Urol1998; 159: 827. Link, Google Scholar 17 : Epididymal obstruction during development results in antisperm autoantibodies at puberty in rats. J Androl1998; 19: 136. Google Scholar 18 : Vasectomy and vasectomy reversal. Br J Urol1994; 73: 337. Google Scholar 19 : Ectopic vas deferens opening into the ureter. Int J Urol1999; 6: 275. Google Scholar 20 : Renal dysplasia: the risk and consequences of leaving dysplastic tissue in situ. Urology1998; 52: 533. Google Scholar Department of Urology, Pediatric Urology Research Center, Children’s Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran© 2006 by American Urological AssociationFiguresReferencesRelatedDetailsCited ByRaveenthiran V and Sam C (2018) Epididymo-Orchitis Complicating Anorectal Malformations: Collective Review of 41 CasesJournal of Urology, VOL. 186, NO. 4, (1467-1472), Online publication date: 1-Oct-2011. Volume 176Issue 6December 2006Page: 2657-2662 Advertisement Copyright & Permissions© 2006 by American Urological AssociationKeywordsvesico-ureteral refluxvas deferensmesonephrosurogenital abnormalitiestricalcium phosphateMetricsAuthor Information Abdol-Mohammad Kajbafzadeh More articles by this author Seyedmehdi Payabvash More articles by this author Expand All Advertisement PDF DownloadLoading ..." @default.
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