Antenatally detected ureterocele: Associated anomalies and postnatal prognosis

• Main Authors: Gurcan Turkyilmaz, Bilal Cetin, Tugba Sivrikoz, Emircan Erturk, Tayfun Oktar, Ibrahim Kalelioglu, Recep Has, Atil Yuksel
• Format: Article
• Language: English
• Published: Elsevier 2019-07-01
• Series: Taiwanese Journal of Obstetrics & Gynecology
• Online Access: http://www.sciencedirect.com/science/article/pii/S1028455919301226

Objective: We purposed to review prenatal diagnoses of ureterocele, to determine the sonographic findings and additional abnormalities, and to illustrate the pregnancy outcomes of these patients. Material and methods: We reviewed the records of 24 patients with the diagnosis of ureterocele in our referral center between January 2010–March 2017. Prenatal sonographic findings, antenatal course, and postnatal follow-up were obtained. Results: The mean gestational age at first US diagnosis was 24.5 ± 2.9 weeks. 13 (54.1%) of fetuses were female, and 11 (45.9%) were male. Ureterocele was associated with the duplex kidney in 17 (70.8%), MCDK in 5 (20.8%) and hydronephrosis with a single system in 1 (4.2%) and pelvic kidney in 1 (4.2%) fetuses. Postnatal follow-up was achieved in 22 of 24 (91.6%) cases, and mean follow-up interval was 56 ± 14.2. Months. The diagnosis of ureterocele was confirmed in 22 (91.6%) cases postnatally. 15 of 22 (68%) cases were classified as extravesical ureterocele, and 7 (32%) cases were intravesical ureterocele. Postnatal confirmation of duplex kidney achieved in 16 of 17 (94.1%) patients. 17 (77.2%) patients were required surgical intervention, and 5 (22.8%) cases were managed conservatively. 15 of 16 (93.7%) cases who were diagnosed duplex kidney underwent surgery however 2 of 5 (40%) cases which were confirmed MCDK required an operation. Cystoscopic ureterocele incision was the initial approach for the surgical management and performed all of the cases which required surgery. It was curative in 10 of 17 (58.8%) patients and 7 (41.2%) cases needed to further operations. Ureteroselectomy and common-sheath ureteroneocystostomy was performed in 5 (29.1%) cases and. 2 (%11.7%) cases underwent partial nephrectomy. Conclusion: Ureterocele can be accurately diagnosed by prenatal sonography, and it is a significant clue for the diagnosis of a duplex kidney. Postnatal prognosis depends on associated anomaly and presence of reflux and upper pole function. Keywords: Kidney, Prenatal diagnosis, Ureterocele, Urinary bladder, Ultrasonography