URETEROCELE ASSOCIATED WITH A SINGLE COLLECTING SYSTEM OF THE INVOLVED KIDNEY

ABSTRACT-Objective. This is a study concerning ureteroceles associated with a single collecting system of the involved kidney. Methods. Over an eight-year period 9 children (5 boys, 4 girls) had a ureterocele sub-tending a single collecting system, whereas 63 children had duplex ureteroceles. Malfor-mations of other organ systems were present in only 1 patient. Results. Three patients have undergone surgical interventions: a transureteral incision of bilateral obstructive ureteroceles in 1 and nephroureterectomy in 2. In 4 cases cys-tic/dysplastic kidneys involuted and were reabsorbed with collapse of the ureteroceles. The last 2 patients have received antibiotic treatment for single episodes of a urinary tract infection. Conclusions. Earlier reports of a high incidence of concomitant anomalies and male predominance in patients with single-system ectopic ureteroceles could not be verified by our experience. Our current policy for a patient is careful evaluation, individualized ther-apy, and long-term surveillance. Congenital obstructive uropathy is currently usually diagnosed early in life by prenatal ultra-sound. Hydronephrosis is the end result of ob-struction at any level of the urinary tract. Prenatal diagnosis is providing the opportunity for long-term surveillance of many obstructive lesions that may lead to elucidation of their natural history.’ Ureteroceles are the third most common cause of prenatal hydronephrosis and usually obstruct the upper pole ureter in a duplex renal unit.l Single-system ectopic ureteroceles are less common but are a distinct entity, with a reported male predom-inance and commonly associated with cardiac anomalies.3 We hereby report a review of our ex-perience with single-system ureteroceles. MATERIAL AND METHODS Seventy-two patients with ureteroceles were eval-uated by the pediatric urology service of the Uni-versity of Michigan in the last eight years. Nine patients (5 boys, 4 girls) had a single collectin