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URETERAL ANOMALIES Pediatric GU Review UCSD Pediatric Urology George Chiang MD Sara Marietti MD Outlined from  The Kelalis-King-Belman Textbook of Clinical Pediatric Urology 2007 (not for reproduction, distribution, or sale without consent)
Sphincteric
Sphincterostenotic
Cecoureterocele
Intravesicle vs Ectopic
URETEROCELES   Demographics ,[object Object],[object Object]
URETEROCELES   Diagnosis ,[object Object],[object Object],[object Object],[object Object]
URETEROCELES     Diagnosis ,[object Object],[object Object],[object Object]
URETEROCELES   Treatment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
URETEROCELES   Treatment ,[object Object],[object Object],[object Object]
URETEROCELES Non-operative managment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
URETEROCELES   Non-operative management ,[object Object],[object Object],[object Object]
Ureteroceles : Endoscopic Managment ,[object Object],[object Object],[object Object]
Ureteroceles : Endoscopic Managment ,[object Object],[object Object],[object Object]
Endoscopic managment ,[object Object],[object Object]
Intravesical Ureterocele
Endoscopic Management : Intravesical ureterocele ,[object Object],[object Object],[object Object]
Extravesical Ureterocele
Endoscopic management : Extravesical Ureterocele ,[object Object],[object Object],[object Object]
Extravesical ureterocele ,[object Object],[object Object],[object Object],[object Object]
Extravesical ureterocele ,[object Object]
Extravesical Ureterocele ,[object Object],[object Object],[object Object]
Upper Tract Approach ,[object Object],[object Object],[object Object],[object Object]
Upper Tract Approach ,[object Object],[object Object],[object Object]
Upper Tract Approach ,[object Object],[object Object]
Upper Tract Approach ,[object Object],[object Object],[object Object]
Upper Tract Approach ,[object Object],[object Object]
Complete Reconstruction ,[object Object],[object Object],[object Object]
Complete Reconstruction ,[object Object],[object Object],[object Object],[object Object]
Complete Reconstruction ,[object Object],[object Object]
Megaureter ,[object Object],King LR: Megaloureter:  Definition, diagnosis and management.  J Urol 1980, 123, 222.
Megaureter ,[object Object],[object Object],[object Object],[object Object],A Megaureter with normal muscle cells. B, Megaureter containing separated muscle cells and ruptured nexus. C, Megaureter containing excessive collagen and ground substance with dying muscle cells.
Megaureter ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Megaureter ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],McLellan DL, Retik A., Peters C., Bauer S., Atala A., Mandell J.  Rate and predictors of spontaneous resolution of prenatally diagnosed primary nonrefluxing megaureter .  J Urol. 2002 Nov;168(5):2177-80
Megaureter ,[object Object],[object Object],[object Object]
Megaureter ,[object Object],[object Object],[object Object],[object Object]
Megaureter ,[object Object],[object Object],[object Object],Defoor W et al.  Results of tapered ureteral reimplantation for primary megaureter : Extravesical vs. intravesical approach. J Urol. 172, pp 1640-1643 Oct 2004
Megaureter ,[object Object],Defoor W et al.  Results of tapered ureteral reimplantation for primary megaureter : Extravesical vs. intravesical approach. J Urol. 172, pp 1640-1643 Oct 2004
Megaureter ,[object Object],[object Object],Ehrlich RM:  The ureteral folding technique for megaureter surgery.  J Urol 134:668, 1985  94.6% success 74 megaureters  Stent for 4-5 days
Megaureter ,[object Object],[object Object],Starr A:  Ureteral plication. A new concept in ureteral tailoring for megaureter.  Invest Urol 17:153, 1979  Reduces lumen 50-60% Severely tortuous ureter
Megaureter ,[object Object],[object Object],Hendren WH:  Complications of megaureter repair in children . J Urol 113:238, 1975  Lower versus total ureteral reconstruction 41% re-operation
UPJ ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
Clinical Presentations ,[object Object],[object Object],[object Object],[object Object],[object Object]
Diagnostics ,[object Object],[object Object],[object Object]
Diagnostics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Diagnostics ,[object Object],[object Object]
Associated GU Anomalies ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
When to Intervene ,[object Object],[object Object],[object Object],[object Object],[object Object]
Postnatal Eval ,[object Object],[object Object],[object Object],[object Object]
Ectopic Ureter
Ectopic Ureter ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Epidemiology ,[object Object],[object Object],[object Object],[object Object]
Associated Anomalies ,[object Object],[object Object],[object Object],[object Object]
Symptoms ,[object Object],[object Object]
Diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Treatment ,[object Object],[object Object],[object Object]
QUESTIONS
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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Pedi gu review ureteral anomalies i

Editor's Notes

  1. Stephens(1958) (classification of ureterocele orifice location) - Stenotic – narrowed opening inside bladder - Sphincteric – orifice distal to bladder neck - Sphicterostenotic – orifice stenotic anddistal to bladder neck - Cecoureterocele – intravesical orifice and submucosal extension into urethra Glassberg Intravesical – ureterocele is contained in bladder in entirety Ectopic – any portion of ureterocele extends to bladder neck or urethra
  2. Stephens(1958) (classification of ureterocele orifice location) - Stenotic – narrowed opening inside bladder - Sphincteric – orifice distal to bladder neck - Sphicterostenotic – orifice stenotic anddistal to bladder neck - Cecoureterocele – intravesical orifice and submucosal extension into urethra Glassberg Intravesical – ureterocele is contained in bladder in entirety Ectopic – any portion of ureterocele extends to bladder neck or urethra
  3. Stephens(1958) (classification of ureterocele orifice location) - Stenotic – narrowed opening inside bladder - Sphincteric – orifice distal to bladder neck - Sphicterostenotic – orifice stenotic anddistal to bladder neck - Cecoureterocele – intravesical orifice and submucosal extension into urethra Glassberg Intravesical – ureterocele is contained in bladder in entirety Ectopic – any portion of ureterocele extends to bladder neck or urethra