Minimally invasive management of the ureterocele

Abstract In order to best plan endoscopic surgery for a child with ureterocele, the pediatric urologist must weigh the age of the child, any associated comorbidities and specific anesthetic risks with the anatomic nuances of the anatomy of the ureterocele and the severity of the changes to the kidney and bladder. The presence of recurrent urinary tract infections (UTIs), the degree of bladder outlet obstruction and, in the older child, the presence of dysfunctional voiding, are important. Is the ureterocele draining the upper pole of a duplex system? Is there associated vesicoureteral reflux (VUR)? Is the renal function of the ipsilateral and contralateral kidney normal or abnormal? All of these, as well as the thickness of the ureterocele, the amount of displacement of the bladder outlet and whether the ureterocele is orthotopic (within the bladder) at a relatively normal position on the trigone or ectopic (passing through the bladder neck) all influence the plan.