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

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.

背景：内镜下经尿道电切术是成人单系统输尿管囊肿的微创治疗选择。膀胱输尿管（VU）反流常与输尿管囊肿相关，可能使治疗复杂化。撒哈拉以南非洲地区关于内镜治疗的文献较少。本研究旨在描述成人原位单系统输尿管囊肿经尿道切开或去顶术的技术方法及疗效。

方法：这是一项针对单系统输尿管囊肿患者的前瞻性研究。所有患者均通过计算机断层扫描尿路造影（CTU）或静脉尿路造影（IVU）确诊，并随访监测症状缓解情况、尿路感染发生情况及膀胱输尿管反流情况。患者的人口统计学信息（如年龄、性别）、内镜治疗细节及随访期间并发症均录入Excel，并使用SPSS 21版进行分析。

结果：10例单系统输尿管囊肿患者共处理18个输尿管单元。男女比例为3:2。30-39岁组（4例，40%）和60-69岁组（4例，40%）占比最高。6例（33.33%）合并结石，83.30%存在下尿路症状（LUTS）。9个输尿管单元（50%）接受了输尿管囊肿经尿道去顶术（TUDU），8个（44.4%）接受了输尿管囊肿经尿道切开术（TUIU）。尿路感染是最常见的并发症。2例术前存在膀胱输尿管反流，2例在TUDU术后出现反流。反流患者经抗生素治疗后同侧症状缓解。所有患者肾功能均得以保留。

结论：接受单系统输尿管囊肿内镜下切开或去顶术的患者中，VU反流发生率较低，且可保守治疗。该术式是单系统输尿管囊肿的有效治疗方法，且并发症极少。