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Ureteric duplication
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Sarah L. Hecht, Duncan T. Wilcox
A ureterocele is a cystic dilatation of the terminal part of the ureter. The embryology is not entirely understood. One theory suggests that ureteroceles result from delayed canalization of Chwalla's membrane, the primitive ureteral membrane that separates the ureteric bud from the developing urogenital sinus. The distal ureteral dilation results from an obstructed or a stenotic orifice. Alternatively, some think that a ureterocele results from abnormal induction of bladder trigonal musculature.
The cases
Published in Chris Schelvan, Annabel Copeman, Jacky Davis, Annmarie Jeanes, Jane Young, Paediatric Radiology for MRCPCH and FRCR, 2020
Chris Schelvan, Annabel Copeman, Jacky Davis, Annmarie Jeanes, Jane Young
Classically the upper moiety has an ectopic insertion, usually into the bladder. There may be an associated ureterocele (seen as a filling defect in the bladder). The ectopic insertion makes the upper moiety prone to obstruction. Insertion into the bladder neck, urethra or vagina results in incontinence.
Pediatric urology
Published in Joseph S. Sanfilippo, Eduardo Lara-Torre, Veronica Gomez-Lobo, Sanfilippo's Textbook of Pediatric and Adolescent GynecologySecond Edition, 2019
Laurel Sofer, Emilie K. Johnson
Treatment options for ectopic ureter/ureterocele include observation, endoscopic procedures, and surgery. The management strategies are controversial, and all options should be discussed with the patient prior to proceeding. The trend in management has veered away from aggressive initial management and toward a more conservative, minimally invasive approach.45
Prenatal diagnosis and outcome of unilateral multicystic kidney
Published in Journal of Obstetrics and Gynaecology, 2021
Gurcan Turkyilmaz, Bilal Cetin, Emircan Erturk, Tugba Sivrikoz, Ibrahim Kalelioglu, Recep Has, Atıl Yuksel, Tayfun Oktar, Orhan Ziylan
The records of 144 patients were diagnosed with MCDK in our referral centre between January 2010 and March 2017. Local ethics committee approval was received (Approval number: 201806112). All of the patients were evaluated by a multidisciplinary team, including maternal-foetal medicine specialists and paediatric urologists. Each woman was considered with regular ultrasound assessments performed transabdominally using an abdominal 2–5 Mhz curvilinear transducer (Voluson, General Electric, Milwaukee, WI). MCDK was diagnosed by ultrasound, which shows multiple non-communicating cysts of various sizes and no evidence of normal renal parenchyma (Figures 1–3). Maximum longitudinal and transverse kidney sections and the anteroposterior dimension of the contralateral kidney's renal pelvis were measured. Hydronephrosis was defined as the renal pelvis anteroposterior diameter was equal to or greater than 4 mm before 28 weeks and equal to or greater than 7 mm after 28 weeks of gestation (Nguyen et al. 2014). The ureterocele presence was evaluated, and ureterocele was defined as cystic, anechoic and thin-walled mass within the bladder. After the initial examination, follow-up scans were scheduled every 4–6 weeks to determine the condition of contralateral kidney and amniotic fluid volume until delivery.
Surgical technique of uretero-ileal anastomosis in patients with bilateral duplex ureters undergoing radical cystectomy and ileal conduit urinary diversion: initial experience
Published in Acta Chirurgica Belgica, 2021
Kavaric Petar, Albijanic Marko, Rebronja Almir, Vukovic Marko
Most duplicated collecting systems are asymptomatic and diagnosed incidentally. Symptoms are due to complications such as obstruction, reflux, ureterocele and infection, and are usually seen in complete duplex urinary tract. There is only few contemporary data describing techniques of radical cystectomy (RC) and intracorporeal neobladder construction with Wallace uretero-ileal anastomosis, in patients with unilateral ureteral duplication [1,2]; however, there is no data that describes the technique of uretero-ileal anastomosis in patients with bilateral duplex ureters. Despite the fact that patients with complete duplex system may exhibit various degree of renal insufficiency, some form of diversion is still necessary. Ileal conduit may represent favourable type of urinary diversion, due to the lower incidence of long-term complications comparing to orthotopic diversions [3]. Nevertheless, the possibility of constructing safe and reliable ureteral plate for uretero-intestinal anastomosis, consisting of four drainage units, remains unclear so far.
Revascularized Pyelo-Uretero-Cystoplasty in Patients with Chronic Bladder Outlet Obstruction Due to Ectopic Ureterocele: A Safe Surgical Technique with Superior Continence Outcomes
Published in Journal of Investigative Surgery, 2022
Asal Hojjat, Shabnam Sabetkish, Abdol-Mohammad Kajbafzadeh
From May 2009 to May 2016, we managed 60 children with ectopic ureterocele in our service; of these, thirteen (10 females and 3 male) with long lasting ectopic obstructive ureterocele stayed incontinent (continuous incontinency as constant leakage of urine) following the ureterocele ablation with an adapted technique consisting fulguration of the internal layers of the ureterocele to support internal layers adhesion subsequent to collapse. We excised the intravesical and urethral portion of the anterior aspect of ureterocele and left its posterior floor intact which provided another source of urothelial-lined tissue for augmentation and prevents damage to the trigone/bladder neck and urethra during massive ureterocele dissection.