ENDOSCOPIC MANAGEMENT OF URETEROCELES IN CHILDREN

Objective: Treatment of ureteroceles in children varies according to t he anatomicopathological form and the choice of the surgical team. Thi s study tries to determine the exact value of the endoscopic managemen t of ureteroceles in children. Methods: Between 1987 and 1993, 11 uret eroceles in 10 children were treated by endoscopic incision: 7 intrave sical ureteroceles (4 single system and 3 duplex system) and 4 duplex- system ectopic ureteroceles. The procedure consists of a tiny transver sal incision at the lower and median aspects of the ureterocele. Resul ts: The dilation of the upper urinary tract disappeared or decreased i n all cases of intravesical ureteroceles and in half the cases of ecto pic ureteroceles. Endoscopic incision of the ureterocele led to a vesi coureteral reflux in the associated ureter in 6 cases: 54.5% (43% of t he intravesical ureteroceles, 75% of the ectopic ureteroceles). Follow ing endoscopic treatment, no further surgery was required in 5 of the 7 cases with intravesical ureteroceles (71.5%), while every case of ec topic ureterocele needed a further operation (lower tract surgery in 3 cases, upper tract surgery in 1 case). Conclusions: Endoscopic incisi on of ureteroceles is a simple and quick procedure which allows obstru ction to be removed and the dilation of the upper urinary tract and it s corresponding kidney function to be improved, particularly in the ne onate. The endoscopic management of ureteroceles may in itself suffice , without necessity of further surgery. These favorable results can mo re readily be seen in cases of intravesical ureterocele than in those of ectopic ureterocele.