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Query: UMLS:C0041960 (ureterocele)
 507 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The epidemiology, clinical presentation, evaluation and methods of surgical management of ectopic ureteroceles was studied. The prenatal detection of hydronephrosis of the upper pole of duplex systems allows early surgical correction, and this effectively decreases the risk of urinary tract infection, urosepsis and irreversible loss of renal function. Yet a precise prenatal diagnosis of accompanying ureterocele is not necessary for efficient postnatal management.
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PMID:[Obstructive ectopic ureterocele: review of the literature in the light of the authors' own experience]. 150 51

To determine the impact of prenatal detection on neonates with hydronephrosis of the upper pole of a duplex collecting system, we reviewed 40 such cases seen between June 1982 and April 1989. This six-per-year rate contrasts with fewer than one case per year that was seen at our hospital from 1947 to 1977. Nineteen patients had an ectopic ureterocele, and 21 had an ectopic ureter without a ureterocele. Thirty-three (83%) were girls. Thirty-three cases were discovered because of abnormal findings on a prenatal sonogram, and 20 of those infants were asymptomatic. In the 33 patients whose prenatal sonographic findings were abnormal, the sonogram was diagnostically precise for hydronephrosis of the upper pole of a duplex collecting system in only 39%. This imprecision did not adversely affect management or outcome. Postnatal sonography modified the prenatal diagnosis in 75% of these 33 patients. Voiding cystourethrography was the most sensitive and precise imaging technique for detecting both ureterocele and reflux. Lower pole reflux was almost twice as common when an ectopic ureterocele was present (63%) than when one was not (33%). Prenatal sonographic detection of hydronephrosis of the upper pole of a duplex collecting system decreased the proportion of neonates presenting with urinary tract infection and urosepsis because of prophylactic antibiotics initiated at birth and continued until surgical correction. Precise prenatal diagnosis was not needed for effective surgical treatment.
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PMID:Importance of prenatal detection of hydronephrosis of the upper pole. 211 33

During a 6-year period (1979-1985), 142 neonates with significant hydronephrosis were seen. Seventy-eight percent of the cases were discovered on fetal screening during obstetric sonography. Maternal/fetal intervention was virtually never indicated and most babies were asymptomatic. The most common conditions found were obstruction of the ureteropelvic junction (41%), obstruction of the distal ureter (usually primary megaureter) (23%), upper-pole hydronephrosis associated with duplex anomalies (13%), and posterior urethral valves (10%). Seventeen neonates with multicystic dysplastic kidney were seen (three per year or one for every eight with hydronephrosis). In comparison, during the 30-year period, 1947-1977, 146 neonates with significant hydronephrosis were seen. Most cases were discovered because the patients had signs and/or symptoms--either an abdominal mass (an enlarged kidney or bladder) or urosepsis. The three most common conditions were obstruction of the ureteropelvic junction (22%), posterior urethral valves (19%), and ectopic ureterocele (14%). During this period, 53 neonates with multicystic dysplastic kidney were discovered (two per year or one for every three with hydronephrosis). The dramatic increase in the number of neonates found to have hydronephrosis is primarily due to the widespread use of obstetric sonography and concomitant fetal screening. The pattern of causes before 1979 represented the incidence of symptomatic lesions. The current pattern more accurately reflects the true incidence of congenital anomalies of the urinary tract.
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PMID:Neonatal hydronephrosis in the era of sonography. 303 9

Nine patients with ectopic ureterocele, complete duplication, and nonvisualization of the upper renal segment are presented. All were managed with heminephrectomy and partial ureterectomy only. The procedure immediately controlled urosepsis, and ultimately was successful in the management of associated reflux. Excision of ureterocele and reimplantation of the ipsilateral ureter was unnecessary.
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PMID:Surgical management of ectopic ureterocele. 721 Mar 76

We reviewed 39 neonates with prenatally diagnosed duplex system anomalies. Principal diagnoses were ureterocele in 15 patients, ureteral ectopia in 15, lower polar vesicoureteral reflux in 6, lower pole ureteropelvic junction stasis in 2 and yo-yo reflux in an incompletely duplicated system in 1. Several patients had other ipsilateral and contralateral urinary anomalies. Ten patients (26%) had relevant physical signs and only 1 became symptomatic, with urosepsis, neonatally. At initial assessment, before any accounted urinary tract infection, renal polar function as judged by radionuclide examinations almost always was severely impaired in the presence of major ureteral ectopia or severe reflux. By contrast, function was usually well preserved when there was obstruction, or lesser degrees of ectopia or reflux. A total of 19 patients underwent surgery (14 electively and 5 after episodes of urosepsis), while 20 have been managed nonoperatively for 12 to 84 months (mean 34) during which time the appearances and function of the upper renal tracts have remained stable. We conclude that the natural history of these anomalies is often benign and that a policy of routine surgical intervention, developed when most cases presented symptomatically, may not be appropriate in patients who present antenatally.
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PMID:Experience with duplex system anomalies detected by prenatal ultrasonography. 845 45

Ectopic ureterocele with ureteral duplication is the most common type of ureterocele found in children. Early accurate diagnosis is desirable to decrease the risk of urosepsis and renal damage. Prenatal imaging with ultrasonography detects the vast majority of ureteroceles; however, in some cases, the diagnosis may remain in doubt. We report on the use of magnetic resonance imaging to clarify the prenatal diagnosis of a prolapsed ureterocele.
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PMID:Prenatal diagnosis of a prolapsed ureterocele with magnetic resonance imaging. 1283 49

The presentation and management of ureterocele has been rarely reported from India and is limited to an odd case report. They can be detected antenatally, may have incidental diagnosis or present with consequences of obstructive uropathy. They always present with secondary complications in adulthood, if the diagnosis and treatment is missed in early years of life. The natural history may be particularly disastrous in cases of bilateral obstructing ureterocele. The complications secondary to obstructive ureterocele can be urinary retention, pyonephrosis, urosepsis, stones and even chronic renal failure. Each of these patients needs an individualized treatment plan. In the period 2003-2013, we managed 36 consecutive patients with varied presentation of this entity. All were managed on the basis of a fixed protocol of investigation and operative intervention. Ultrasound, micturating cystourethrogram, isotope renogram were done preoperatively in all the babies. Those with asymptomatic, unobstructed ureteroceles were left without any intervention. Simple or complex intravesical ureteroceles underwent examination under anesthesia and endoscopic deroofing and DJ stenting for 3 weeks. Of a total of 36 children, 6 were presented with acute complications of ureterocele. They have been managed on an individualized optimum management plan. Their management approach with follow-up is being reported as there is no previous reported series on ureterocele in children from our country.
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PMID:Management of complicated ureteroceles: Different modalities of treatment and long-term outcome. 2519 94