Transurethral incision of a ureterocele in children under ultrasound control

Introduction Transurethral incision (TUI) is a popular method of treatment used in children with ureteroceles. The procedure can be difficult because of dimensions, localization and thickness of a ureterocele as well as its relation to other ureteral orifices. The aim of the present study was to evaluate the usefulness of ultrasound guidance for incision of a ureterocele and decompression of the upper urinary tract during endoscopy. Material and methods Analysis included 34 children treated for ureteroceles at the Department of Paediatric Surgery and Traumatology in Lublin between 2005 and 2015. A ureterocele in a duplicated collective system was noted in 24 children. Twenty children with the functional upper system underwent TUI. Four children with the nonfunctional system were subjected to classical surgical procedures. A ureterocele in a single collective system was treated with TUI in 10 children. The correctness of incisions was controlled with ultrasound during cystoscopy. No urinary outflow obstruction, vesicoureteral reflux or urinary infections were observed, which implies good long-term outcomes. Results Endoscopic treatment resulted in good shortand long-term outcomes in all children with the functional upper system of a duplicated kidney. In the remaining patients with the non-functional upper system, good outcomes were observed following classical surgical procedures. Endoscopic treatment yielded good shortand long-term results in all patients with single system ureteroceles. Conclusions Endoscopic incision of a ureterocele is the treatment of choice in cases with good renal function. Ultrasound guidance during ureterocele incision improves the efficacy and safety of the procedure.