Endoscopic Puncture Versus Classic Incision for Pediatric Ureterocele: Comparative Outcomes

Ibrahim, Hisham Ibrahim; Abouela, Waseem; Kotb, Sameh; Eladawy, Mahmoud Shoukry; Shaker, Hossam

doi:10.21608/eju.2025.389125.1033

Endoscopic Puncture Versus Classic Incision for Pediatric Ureterocele: Comparative Outcomes

Document Type : Original Article

Authors

¹ Department of urology Cairo university

² Urology department , Cairo University, Cairo,Egypt

³ Urology department , Fayoum University, Fayoum, Egypt

⁴ Urology department, Fayoum university,Fayoum,egypt

10.21608/eju.2025.389125.1033

Abstract

Objective: This study aims to evaluate and compare the outcomes of two commonly used endoscopic surgical techniques—puncture and classic incision—for the treatment of pediatric intravesical ureterocele in patients with duplicated collecting systems.

Methods: We conducted a prospective study involving 34 children with unilateral intravesical ureterocele associated with a duplex renal system, treated between April 2023 and October 2024 at two major university hospitals. Patients were randomized into two groups. Group A (n=17) underwent endoscopic puncture decompression, while Group B (n=17) received a classic transverse incision using an electrocautery knife. Data collected included demographics, presenting symptoms, preoperative imaging, postoperative vesicoureteral reflux (VUR), and the need for secondary interventions.

Results: The puncture group exhibited a postoperative de novo VUR rate of 5.9%, whereas the incision group showed a rate of 23.5%. Reintervention was required in 0% and 11.8% of cases in Groups A and B, respectively. Both groups had full symptomatic resolution, but the puncture group demonstrated more consistent improvement on ultrasonography. Though statistical significance was not reached, the clinical trends favored the puncture technique.

Conclusion: Endoscopic puncture appears to be a safe and effective alternative to classic incision for decompression of pediatric ureteroceles. It is associated with fewer postoperative complications and may preserve the natural anti-reflux mechanism better. These findings support considering puncture as a first-line treatment in selected pediatric cases.

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