Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0041960 (ureterocele)
 507 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Experience is described of 41 infants and children with duplex-system ureteroceles, 25 presenting clinically and 16 by prenatal ultrasonography. Bladder outflow obstruction was rare but lower polar vesicoureteric reflux (VUR), usually of lesser grades, was common. Upper polar function, as assessed by 99mTc-DMSA, was negligible in children with truly ectopic ureteroceles but well preserved in those where the lesion lay wholly intravesically. Lower polar function was good, even in the presence of secondary obstruction, except in 2 infants with major VUR. Twenty-three patients were treated by upper polar nephrectomy plus aspiration of the ureterocele; 2 subsequently required ureterocele excision. Histology of excised specimens indicated that a more conservative approach would not have been rewarded. Where upper polar function was good, conservation was maintained in 3 cases by pyelopyelostomy and in 5 more by excision of the ureterocele plus bipolar ureteric reimplantation. Other operative strategies were employed in 2 cases. Finally, a defined group of 8 children was managed expectantly without untoward results. It was concluded that the variable anatomy and function associated with duplex-system ureteroceles require a flexibile approach to treatment, including, possibly, no treatment at all.
 ...
PMID:Current management of duplex-system ureteroceles: experience with 41 patients. 139 43

Since 1986 we have performed suction of the ectopic ureteroceles in seven cases. In four of these cases the obstruction caused by the ureteroceles affected the upper hemi-kidney. In the remaining three cases both hemi-kidneys of the same side were affected. One child suffered failure of both hemi-kidneys. All the ureteroceles corresponded to the upper hemi-kidney and were associated with ipsilateral duplicity. In four of the cases the treatment applied was the heminephrectomy of the upper hemi-kidney and the suction of the ureterocele. In one case, we did a nephrectomy and suction of the ureterocele. In the remaining two cases the suction of the ureterocele was done, as well as the ureteropyelostomy, since it was necessary to use the upper hemi-kidney in the renal TC99m dimercaptosuccinic acid scan-DMSA. In five of the children there was a collapse of the ureterocele giving good results in both kidneys. In two of the children there was no collapse, which provoked the need for removal of the ureterocele. In one of these two cases, the renal dilatation persisted later. In the last case it was necessary to perform nephrectomy due to the absence of recuperation of the renal function. Three of the children had associated reflux which disappeared in one of them, after the suction of the ureterocele. Vesical surgery might be avoided by means of the ureterocele's suction technique in 60 per 100 of the cases. However, it is essential to pursue the child's progress once every six months, in order to detect possible failures of ureterocele collapse.
 ...
PMID:[Our experience with aspiration of ectopic ureteroceles]. 193 92

Twenty-eight cases of ectopic ureters are reviewed. Two groups consisting of single ectopic ureters and ectopia associated with duplex systems are considered. The former is associated with a high incidence of congenital anomalies. A dilated ectopic ureter remains completely extravesical but can produce features closely resembling those of an ectopic ureterocele. The use of 99mTc-DMSA renal scan has proved helpful in the diagnosis of the condition because it can demonstrate the existence of a poorly functioning kidney not evident on excretion urography.
 ...
PMID:Ureteric ectopy in children. 742 90

To answer the question about the best therapeutic procedure in duplex ureteroceles a prospective and retrospective study was performed. In a first group we summarized the patients operated from 1971 to 1986. These infants and children were compared to a group operated from 1987 to 1992. In the first group the operative procedure was chosen according to the presence or absence of reflux into the lower pole system. All patients with reflux were corrected radically in one operation. The control showed a reoperation rate of 45% (8 of 18 patients). 3 patients lost a functioning renal unit. In the second group the operative procedure was chosen according to the function of the upper pole. It was resected if its function was below 10% measured by DMSA-scintigraphy. In cases with functioning upper pole a pyeloureterostomy was performed. Only in two cases the ureterocele was resected primarily. In this group a second operation was necessary in only 3 of 16 patients and renal function was preserved in all cases. Our results show that radical surgery in duplex ureteroceles is seldom necessary and a staged procedure is the method of choice.
 ...
PMID:Duplex ureteroceles: is radical surgery always necessary? 798 Nov 67

From 1981 to 1993, we have treated 31 pediatric patients with ectopic ureterocele (associated to duplex system, intra and extravesicals). Diagnostic work-up included abdominal ultrasound, intravenous urography (IVU), sequence mictional cystouretrography (SM-CU) and diuresis renography (DTPA-DMSA o MAG-3). Patients were divided in two groups: 1. Good renal function in the affected system (5 cases) with 2 endoscopic incision of the ureterocele and 3 without surgical treatment (all intravesical). 2. Almost non-existent ipsilateral renal function (26 cases), treated by heminephrectomy and ureterocelic aspiration, and in the remaining a nephrectomy was done for ipsilateral non-existent renal function. 2 cases treated by endoscopic incision presented vesicoureteral reflux, and 4 cases treated by nephrectomy had a low grade reflux. There is no a definite treatment established. The choice should by made based on renal function. Endoscopic incision is a good choice in obstructed cases with good renal function. In those with no function at all, heminephrectomy with aspiration of the ureterocele will be the best treatment if we consider that almost 50 percent of the patients will need a second surgical procedure.
 ...
PMID:[Surgery of ectopic ureterocele in children: strategy based on prenatal function]. 852 14

Ureterocele is a congenital urinary abnormality characterized by the presence of an intra-bladder hernia or cystic ballooning of the lower end of a ureter between the mucosa and muscle of the bladder. The abnormality leads to urinary retention and recurrent urinary tract infection which can cause irreversible damage to the kidney. Antenatal ultrasound diagnosis of ureterocele is possible but remains difficult. The disease is confirmed during radiologic examination after birth, and renal function is assessed by 99mTc-DMSA. Ureterocele, while not an uncommon pediatric urologic problem, has been reported only rarely in adults. It is bilateral in 10% of cases, is rare in black people, and requires thoughtful management decisions. A relatively uncommon case of bilateral ureterocele with single ureter, associated with left vesicoureteral reflux, in African black man is reported. The patient was investigated by ultrasonography and intravenous urography. Surgical transvesical right "osteoplasty" and excision of the left ureterocele plus ureteric reimplantation, using Politano-Leadbetter technique, were performed. The surgical approach to ureterocele is discussed and we underlined the difficulty of therapeutic decisions, especially if surgery is considered.
 ...
PMID:[Unusual presentation of bilateral ureterocele in an adult Black male. Clinical case]. 856 Mar 56

Sixty four cases of ureteroceles in a context of pyeloureteric duplication were reviewed. They were detected antenatally in 69% of cases. Upper pole nephroureterectomy was performed as first-line procedure in 32 cases. In 37.5% of cases, this procedure was followed by lower tract reconstruction, essentially because of symptomatic reflux in the inferior renal pelvis. Complete renal and vesical reconstruction was performed as the first-line procedure in 6 cases. An ureteropelvic anastomosis allowed preservation of the superior renal pelvis in 4 cases, including one case with secondary lower tract reconstruction. Intravesical reimplantation of the two ureters was performed in 8 cases. Primary endoscopic opening of the ureterocele was performed in 10 cases and complementary surgery was required in 7 cases. Other procedures were used more rarely: temporary ureterostomy, nephrostomy, resection of the protruding dome of a cecoureterocele. Current management is usually neonatal. The first step consists of prevention of infection. The therapeutic approach depends on the quality of the superior renal pelvis assessed by DMSA renal scintigraphy. Immediate complete reconstruction of the kidney and bladder is now rarely indicated. When the superior renal pelvis is not functional, resection should be considered with aspiration of the ureterocele. A complementary bladder procedure is required in some cases (40% in our series) to treat symptomatic reflux in the inferior renal pelvis. When the superior renal pelvis is functional, ureteropelvic anastomosis is a good solution, especially when the superior ureter is very large and poorly functional, but endoscopic opening of the ureterocele can also be proposed, which may need to be followed be intravesical reconstruction.
 ...
PMID:[Management of ureteroceles with pyelo-ureteral duplication in children. Report of 64 cases]. 1054 42