ECTOPIC URETEROCELE

Abstract

Our experiences in the management of 14 ectopic ureteroceles during the last 8 and half years are described. There were 11 complete ureteral duplications and 4 single ureters. The criteria of ectopic ureterocele depends on the position of the orifice on the cele wall, but in about one third of the cases, the orifices were not clearly confirmed. Most of the cele ureters were tortuous and dilated, but 3 ureters were narrow and atretic. Histologic findings of the kidney of these atretic ureters showed severe dysplasia. Vesicoureteral reflux of the cele ureter was noted in 5 children. There was a cecoureterocele, the distal wall of which extended deep in the urethra like a submuscosal tongue and the orifice was wide open with massive reflux. As the treatment of this entity, nephroureterectomy or heminephroureterectomy is the common choice of operation for the nonfunctioning, dysplastic kidney. We make the onestage operation on both renal segment and distal end of the ureter. In four patients who showed residual function of the upper kidney, reimplantation of the ureter was performed. Resection of the distal end of the cele wall has much difficulties and the follow-up examination in detecting the cele remnant by micturating cystourethrography or endoscopy is required. The importance of simultaneous management of the twin mate ureter in duplex system is stressed.
The Japanese literature of the ectopic ureterocele are reviewed.