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19–22 APRIL, 2017, BARCELONA, SPAIN
MATERIAL AND METHODS
One hundred POM in 92 consecutive patients were treated by EBD between years 2004-2016.Atotal
of 70 POM (64 patients) with more than 18 months of follow-up after treatment were retrospectively
analyzed. EBD of the vesicoureteral junction was performed with semicompliant high-pressure
balloon catheters (2.7FG) with minimum balloon diameter of 3 mm, followed by Double-J stent
placement. Follow-up protocol included periodical clinical reviews, US and MAG-3 renogram scans.
RESULTS
Median age at surgery was 4 months (15 days-3.6 years), with median operating time of 20 minutes
(10-60) and hospital stay of 1 day (1-7). Endoscopic approach of POM had a long-term success
rate of 85.7%. Initial renal function was preserved in all patients with normalization of the renogram
elimination curves. Significant differences were observed in ureteral diameter before, after EBD
and in long-term (p<0.001). Secondary VUR was found in 16 cases (24.6%), being successfully
treated by endoscopic subureteral injection in 12 (75%). Endoscopic management of POM failed
in 10 cases (14.3%) that required ureteral reimplantation. Five were early failures (4 intraopera-
tive technical problems and 1 double-J stent migration with severe re-stenosis), and 5 long-term
(4 persistent VUR and 1 re-stenosis recurrence). Median follow-up was 5.9 years (1.5-12.5).
CONCLUSIONS
EBD has shown to be an effective treatment with few complications and good outcomes at long-
term follow up. Secondary VUR can also be treated endoscopically with a high success rate. In our
opinion, EBD may be considered first-line treatment in POM. However, it doesn’t invalidate other
surgical options in case of failure.
S17-12 (P without presentation)
URETEROCELE EXCISION WITH URETERS
REIMPLANTATION IN DUPLEX SYSTEM
Gabriela GROCHOWSKA, Piotr GASTOL and Malgorzata BAKA-OSTROWSKA
Children’s Memorial Health Institute, Warsaw/Poland, Pediatric Urology, Warsaw, POLAND
PURPOSE
The aim of this study is to evaluate surgical excision of ureterocele with ureters reimplantation in
patients with duplex system after unsuccessful primary treatment (endoscopic incision or upper pole
heminephrectomy with decompression of ureterocele).
MATERIAL AND METHODS
We retrospectively reviewed 21 children with ureter duplication and ureterocele who underwent
surgical excision of ureterocele with ureter(s) reimplantation between 2003 and 2013.
There were 14 girls and 7 boys, age from 1,5 to 13 years (median 3 years).
Initially, endoscopic incision of ureterocele was performed in 15/21 children with good isotopic
function of the upper pole and heminephrectomy with decompression of ureterocele was done in
6/21 cases with poor function of the upper pole.
Indications and outcomes of the surgical excision of ureterocele with ureter(s) reimplantation were
evaluated based on clinical patterns (UTI’s, post-void residual urine) and voiding cystography
(VCUG).
Follow-up time ranged from 2 to 12 years (median 7 years).
RESULTS
Due to recurrent UTI’s, post-void residual urine or vesicoureteral ref lux (VUR) during the observation
after primary treating all patients required open ureterocele excision and ureter(s) reimplantation.
Incidence of above symptoms was observed during follow-up period (Tab. 1):