The Outcome of Transurethral Electro-Endoscopic Resection of Orthotopic Single System Ureterocoeles in Adults Nigerians.

Abstract

Background: Endoscopic transurethral electro-incision and resection are minimally invasive options for treating adult single system ureterocoele. Vesicoureteral (VU) reflux is frequently associated with ureterocoeles and can complicate the treatment. The literature on endoscopic management is scanty from sub-Saharan Africa. This study aimed to describe the technique and outcome of adult patients who had transurethral incision and or deroofing of orthotopic single system ureterocoele.

Methodology: This was a prospective study on patients who presented with single system ureterocoeles. All were diagnosed either by computerized axial tomography urography or intravenous urography and were followed up and monitored for resolution of symptoms, development of urinary tract infection, and ureterovesical reflux. The patients’ demographic information such as their age, sex, details of endoscopic treatments, complications on follow-up were entered into Excel and analyzed using SPSS version 21.

Results: There were eighteen ureteric units managed in 10 patients with single system ureterocoeles.  The male: female ratio was 3:2. The 30-39year age group (four; 40%) and 60-69year age groups (four; 40%) had the highest frequency. Six (33.33%) had calculi, and 83.30% presented with lower urinary tract symptoms (LUTS). Nine (50%) of the ureteric systems had transurethral deroofing of ureterocoele (TUDU), while eight (44.4%) had transurethral incision of ureterocoele (TUIU). Urinary tract infection was the commonest complication.  Ureterovesical reflux was present in two and two developed refluxes after TUDU. The patients with refluxes had antibiotics with the resolution of the ipsilateral symptoms. All had preserved renal function.

Conclusion: VU reflux in patients that underwent endoscopic incision or deroofing for single system ureterocoele is infrequent and can be managed conservatively. It is an effective treatment for single-system ureterocoeles and has minimal complications.