HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

Duplex system ureterocele in infants: should we reconsider the indications for secondary surgery after endoscopic puncture or partial nephrectomy?

AbstractOBJECTIVE:
We assessed outcomes and need for secondary surgery after primary trans-urethral puncture (TUP) or upper pole partial nephrectomy (UPPN) in duplex system ureterocele (DSU) patients undergoing management that disregards vesicoureteral reflux and upper pole function.
SUBJECTS AND METHODS:
Between 2003 and 2010, 41 DSU <1 year underwent TUP (n = 32) or UPPN (n = 9). Postoperatively, additional investigations and surgery were limited to cases showing persistent hydroureteronephrosis or developing recurrent febrile urinary tract infections (UTI). Outcome parameters included upper tract decompression, UTI after decompression, continence status, and secondary surgery rate. Preoperative variables were compared between patients who required secondary surgery and those who did not.
RESULTS:
Additional surgery was required for persistent hydroureteronephrosis in 20% of cases after TUP vs none after UPPN. After decompression, 4 female patients developed recurrent febrile UTI and 2 required additional surgeries. No case suffered from urinary incontinence. After a median (range) follow-up of 46 (17-102) months, TUP or UPPN was the only surgery required in 32 (78%) cases irrespective of preoperative variables.
CONCLUSION:
UPPN seems more effective than TUP in decompressing severely dilated urinary tracts. After decompression, disregarding VUR status and upper pole function, TUP or UPPN is the only procedure required in 80% of DSU cases, regardless of preoperative variables.
AuthorsMarco Castagnetti, Enrico Vidal, Marta Burei, Pietro Zucchetta, Luisa Murer, Waifro Rigamonti
JournalJournal of pediatric urology (J Pediatr Urol) Vol. 9 Issue 1 Pg. 11-6 (Feb 2013) ISSN: 1873-4898 [Electronic] England
PMID22819760 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
CopyrightCopyright © 2012 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.
Topics
  • Child
  • Child, Preschool
  • Decompression, Surgical (methods)
  • Endoscopy (methods)
  • Female
  • Fever (etiology)
  • Follow-Up Studies
  • Humans
  • Infant
  • Male
  • Nephrectomy (methods)
  • Postoperative Complications (surgery)
  • Reoperation (methods)
  • Retrospective Studies
  • Treatment Outcome
  • Ureterocele (surgery)
  • Urinary Tract Infections (complications, surgery)

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: