Ureteral duplications and ureteroceles - surgical treatment

Abstract

To study clinical and radiological data and surgical treatment for symptomatic ureteral duplications in childhood, especially the results for superior polar heminephrectomies. Prospective observational study concerning 15 pediatric patients surgically treated following a protocol with a minimum follow-up of 6 months. 93% of the patients presented urinary infection and/or fetal hydronephrosis during their first year of life. These were the usual reasons for evaluation. Superior polar heminephrectomy was indicated for 80% of the patients, all of whom presented clinical and radiological improvement after the surgery. There were no significant complications. All children with severe vesicoureteral reflux to the duplicated superior pole presented symptomatic reflux to the stump after the surgery and were submitted to stumpectomy. None of the patients without preoperative reflux needed any other surgical procedure. Superior polar heminephrectomy is safe and efficient in order to treat ureteral duplications in childhood. If the patient does not present vesicoureteral reflux this will probably be the only surgery needed. Most patients with reflux to the resected superior pole will need stumpectomy subsequently.