Outcomes of Duplex System Ureteroceles in Pediatric Patients Managed Primarily with Transurethral Incision
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Keywords

ureteral surgery
endoscopy
duplex system

How to Cite

Tan, M. A., & Bolong, D. . (2020). Outcomes of Duplex System Ureteroceles in Pediatric Patients Managed Primarily with Transurethral Incision. Philippine Journal of Urology, 28(1), 46-52. Retrieved from https://pjuonline.com/index.php/pju/article/view/64

Abstract

Transurethral incision of ureterocele (TUI-U) is a simple, quick, less invasive, and less expensive, and an effective procedure for the management of ureteroceles. Several studies have already shown its utility for primary management of ureteroceles but it has also been associated with the need for additional surgery. The authors reviewed charts of patients from their database to describe the outcomes of TUI-U done in ureteroceles associated with the upper pole moiety of a duplex system. They also looked into preoperative patient characteristics and post TUI-U outcomes that could influence the need for subsequent surgeries.

Materials and Methods: The authors identified patients from their duplex system database who presented with a ureterocele and underwent TUI-U. They reviewed the patient records of 25 patients who were included in the study to determine the outcomes of TUI-U in duplex system ureteroceles. Chi square and Mann Whitney U tests were used to determine whether preoperative patient features and post TUI-U outcomes were associated with secondary surgery.

Results: Out of 65 patients who had duplex system ureteroceles, 25 patients (38.4%) underwent TUIU at a mean age of 1.51 years old. TUI-U alone was successful in improving the prevalent signs and symptoms of 15 patients (60%) in this group, while 10 patients (40%) had to undergo subsequent surgical procedures. Breakthrough urinary tract infection (UTI) post TUI-U was the only patient factor noted to be significantly associated with a secondary surgery for duplex system ureterocele (p=0.027).

Conclusions: TUI-U as primary treatment for duplex system ureteroceles is not yet widely accepted due to reported rates of morbidities and need for secondary surgery. Present data however show that TUI-U can be used as a primary procedure and even as a definitive procedure for this subset of patients with remarkable results in terms of symptoms resolution and improvement of upper tract profiles.

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