Ureteroceles in children: clinical study and report of 58 cases.

Fifty-eight children with ureteroceles are the subject of this study. The lesions occurred more commonly in females and affected the left urinary transport system predominantly. Ectopic ureterocele was the most common type and virtually always developed on the ureter originating from the upper renal unit of a duplex kidney. There was a high incidence of associated urinary tract obstruction or vesico-ureteral reflux. The most common presenting symptoms were those of urinary infection followed by discovery of an abdominal mass. A characteristic filling defect in the bladder was seen on excretory urogram, and voiding cystourethrography revealed vesicoureteric reflux in 50% of the patients. Management of an infant or child with a ureterocele should begin with appropriate antibiotic treatment if infection is present, followed by excision or drainage of the involved renal segment(s). A pus filled upper pole and ureter may need to be removed or drained urgently in some ill patients. Ureteroceles are often complicated anatomic problems, which should be treated by surgeons who are familiar with the various facets of this congenital malformation.