Cystoscopic transurethral incision in simple and duplex ureteroceles – is it the definitive procedure?

Abstract Objective The aim of this study is to evaluate the efficacy of primary cystoscopic transurethral incision (CTUI) in the management of pediatric ureteroceles. The secondary aim is to compare the efficacy of CTUI between simplex and duplex systems. Patients and methods Retrospective review of consecutive pediatric patients requiring surgical intervention for ureterocele. Data collected for analysis included: demographics, diagnostic, pre-operative investigations, operative interventions and post-operative variables. Results Over a 19 year period 79 consecutive cases were identified, and 42 were male (53.2%). The mean follow-up was 6.7 years. Seventy-three (92.4%) cases underwent primary CTUI, 50 of these cases (68.5%) required no further procedures during the study period. Sixty-one cases were treated by endoscopic intervention alone (77.2%). Forty-one (51.9%) cases had a simplex system and 38 (48.1%) a duplex system. There was no statistically significant difference in the efficacy of primary CTUI in simplex vs duplex systems. Of the 20 patients that had pre- and post-operative micturating cystourethrograms performed seven (35%) developed de-novo post-operative VUR following CTUI. Conclusion Primary CTUI is a safe, minimally-invasive procedure that is definitive in the majority of children presenting with a ureterocele that requires intervention. There was no difference in success of primary CTUI between simplex or duplex systems.