INTERNATIONAL MULTIDISCIPLINARY JOURNAL FOR
RESEARCH & DEVELOPMENT
SJIF 2019: 5.222 2020: 5.552 2021: 5.637 2022:5.479 2023:6.563 2024: 7,805
eISSN :2394-6334 https://www.ijmrd.in/index.php/imjrd Volume 12, issue 03 (2025)
206
EFFECTIVENESS OF ENDOSCOPIC TREATMENT OF DOUBLE URETER
URETEROCELE IN CHILDREN
Turakulov Zoirjon Shokirovich
Assistant of Children's Surgery Department for treatment
Andijan State Medical Institute
Abstract.
A retrospective study of 155 pediatric patients with ureterocele of a duplicated ureter was
conducted. The age of the patients at the time of surgery ranged from 5 days to 17 years (median,
8.0 months). Intravesical ureterocele was detected in 108 children (69.8%), and extravesical
ureterocele was detected in 47 patients (30.2%).
Kеywоrds:
ureterocele; ureteral duplication; transurethral dissection.
INTRОDUСTIОN
Ureterocele is a congenital anomaly of the ureter development, characterized by cystic expansion of
its distal section due to narrowing of the orifice, which leads to impaired urodynamics and the
development of megaureter. There are several classifications of ureterocele based on anatomical
features. Two features have the greatest clinical significance: the presence or absence of ureter
duplication and the localization of ureterocele. Previously, ureterocele was divided into orthotopic,
not associated with ureter duplication, and ectopic, associated with a double ureter [1]. Currently,
the most commonly used classification distinguishes between ureterocele of a doubled and non-
duplicated ureter, as well as intravesical ureterocele located in the bladder, and extravesical
ureterocele opening in the neck of the bladder or urethra [2].
MАTЕRIАLS АND MЕTHОDS
Treatment of children with ureterocele due to ureteral duplication is a challenging task for pediatric
urologists. The main goals of treatment are to preserve renal function, eliminate urinary
incontinence if present, and prevent urinary tract infections (UTIs) with a minimum number of
surgical interventions [3]. There is no generally accepted universal approach to achieve these goals.
When choosing a treatment for ureterocele, the patient's age, the degree of renal dysfunction, the
size and location of the ureterocele, the degree of megaureter, the presence of vesicoureteral reflux
(VUR), and bladder neck obstruction are taken into account. Transurethral incision of ureterocele
(TURU) is the most popular, safe, and minimally invasive option for the primary treatment of
ureterocele [3]. Studies have shown that in many patients, endoscopic decompression of ureterocele
is the first and definitive procedure, and more invasive subsequent operations should be performed
only if strictly indicated in the presence of clinical manifestations of the disease, regardless of the
presence of VUR and the degree of loss of renal function [1]. However, there are also proponents of
a more invasive approach for the primary treatment of ureterocele [2]. It consists of
heminephrectomy of the upper pole of the kidney or reimplantation of the ureter with removal of the
ureterocele. Proponents of this approach justify it by the fact that in most cases after TURU,
repeated interventions are necessary due to the non-functioning upper half of the kidney and UTI
against the background of VUR.
RЕSULTS АND DISСUSSIОN
In case of intravesical ureterocele, a vertical incision of its wall in the distal part was made for 5 mm.
In case of extravesical ureterocele, its entire urethral part was dissected up to the intravesical section.
Drainage of the urinary bladder with a urethral catheter was used only in cases of emergency
surgery in 12 patients (7.7%) with obstructive pyelonephritis or obstruction of the ureterocele of the
bladder neck. On the next day after the surgery, all children underwent ultrasound examination to
confirm the elimination of obstruction. Long-term antibacterial prophylaxis was prescribed to
INTERNATIONAL MULTIDISCIPLINARY JOURNAL FOR
RESEARCH & DEVELOPMENT
SJIF 2019: 5.222 2020: 5.552 2021: 5.637 2022:5.479 2023:6.563 2024: 7,805
eISSN :2394-6334 https://www.ijmrd.in/index.php/imjrd Volume 12, issue 03 (2025)
207
prevent UTI for the period of outpatient observation until a control X-ray examination. All patients
who underwent endoscopic treatment, after 6-12 months. After the operation, an examination was
performed, including laboratory and ultrasound studies, micturition cystourethrography. In toilet-
trained children, uroflowmetry was performed to assess urination. Based on the examination results,
the dynamics of dilation of the ureter and renal pelvis-calyceal system, the presence of UTI,
urination disorders and VUR were assessed. Static nephroscintigraphy with dimercaptosuccinic acid
labeled with the isotope technetium TC-99m was used to assess the functional state of the kidney.
The degree of renal dysfunction was determined by the intensity and uniformity of accumulation of
the radiopharmaceutical. Depending on this, we classified the state of the upper pole as non-
functioning, poorly functioning and normally functioning.
To check the normality of the distribution of the obtained sets of quantitative characteristics, the
Kolmogorov–Smirnov test was used. When comparing independent sets, the Mann–Whitney U test
was used. To analyze the qualitative characteristics, the correspondence coefficient c2 and the two-
sided version of the Fisher exact test were used. Regardless of the analysis method, the differences
between the groups were considered statistically significant with a probability of an error-free
forecast of at least 95% (p < 0.05).
In the early postoperative period (within one month after surgery), complications requiring repeated
endoscopic intervention occurred in 2 patients (1.3%). In the first case, bladder tamponade
developed on the day after surgery due to bleeding from the incision edge on the ureterocele wall.
Repeated cystoscopy was performed, tamponade was eliminated, and bleeding was stopped by
coagulation of the bleeding vessel.
СОNСLUSIОN
TURU for ureteral duplication is an effective and safe minimally invasive method for eliminating
obstruction, which can be used at any age. The incidence of complications in the early postoperative
period that required repeated endoscopic surgery was 1.3%, recurrence of obstruction was noted in
0.6% of patients. VUR on the side of the ureterocele after TURU was diagnosed in 72.3% of
patients, repeated surgical intervention in the late period after TURU was required in 62.5%.
Surgical treatment was performed only in the presence of recurrent UTIs and urinary dysfunction
caused by ureterocele. Risk factors associated with the need for reoperation were VUR on the side
of the ureterocele and the absence of function of the upper pole of the kidney.
RЕFЕRЕNСЕS
1.
Kuzieva, S. U., Imomova, D. A., & Duschanova, G. M. (2019). Structural features of
vegetative organs Spiraea hypericifolia L., growing in Uzbekistan.
American Journal of Plant
Sciences
,
10
(11), 2086-2095.
2.
Кузиева,
С.
У.,
&
Ишонкулова,
Д.
У.
(2018).
ВЫДЕЛЕНИЕ
И
ЭЛЕКТРОФОРЕТИЧЕСКИЕ СВОЙСТВА МАЛАТДЕГИДРОГЕНАЗЫ ХЛОПЧАТНИКА.
In
INTERNATIONAL SCIENTIFIC REVIEW OF THE PROBLEMS AND PROSPECTS OF
MODERN SCIENCE AND EDUCATION
(pp. 14-16).
3.
Фозилов, Х. Г., Шек, А. Б., Бекметова, Ф. М., Алиева, Р. Б., Мухамедова, М. Г.,
Муллабаева, Г. У., ... & Хотамова, М. Н. (2021). Особенности деформационных свойств
левого желудочка у больных с поражением коронарных артерий.
Клиническая и
экспериментальная хирургия
,
9
(3), 118-124.
4.
Shoxabbos, S., & Mahramovich, K. S. M. K. S. (2023). Causes of the origin of
cardiovascular diseases and their protection. IQRO JURNALI, 1-6.
5.
Abdurashidov, A., & Turdaliyeva, N. (2023). DEVELOPMENT OF MANUAL WORK IN
PRE-SCHOOL EDUCATION.
Science and innovation
,
2
(B2), 282-286.
INTERNATIONAL MULTIDISCIPLINARY JOURNAL FOR
RESEARCH & DEVELOPMENT
SJIF 2019: 5.222 2020: 5.552 2021: 5.637 2022:5.479 2023:6.563 2024: 7,805
eISSN :2394-6334 https://www.ijmrd.in/index.php/imjrd Volume 12, issue 03 (2025)
208
6.
qizi Turdaliyeva, N. A. (2024). MAKTABGACHA YOSHDAGI BOLALAR IJODIY
QOBILIYATLARNI RIVOJLANTIRISHNING NAZARIY ASOSLARI.
GOLDEN BRAIN
,
2
(7),
48-52.
7.
Sobirjonovich, S. I. (2023). Systemic Organization of Professional Competence, Creativity
and Innovative Activity of A Future Kindergartener.
Journal of Pedagogical Inventions and
Practices
,
19
, 108-112.
8.
qizi Boymirzayeva, S. O. (2024). MAKTABGACHA TA’LIM TASHKILOTIDA BO
‘LAJAK TARBIYACHINING KREATIVLIGINI RIVOJLANTIRISH.
GOLDEN BRAIN
,
2
(7), 41-
47.
9.
Мухамедова, М. Г., Куртиева, Ш. А., & Назарова, Ж. А. (2020). СИНДРОМ
ФУНКЦИОНАЛЬНОЙ КАРДИОПАТИИ У СОВРЕМЕННЫХ ПОДРОСТКОВ. In
П84
Профилактическая медицина-2020: сборник научных трудов Все-российской научно-
практической конференции с международным участи-ем. 18–19 ноября 2020 года/под ред.
АВ Мельцера, ИШ Якубовой. Ч. 2.—СПб.: Изд-во СЗГМУ им. ИИ Мечникова, 2020.—304 с.
(p.
105).
10.
Mukhamedova, M., Orziev, D. Z., Uzokov, J. K., & Abdullaev, A. X. (2023). Optimization
of antiplatelet therapy in patients with coronary artery disease and type 2 diabetes mellitus after
percutaneous
coronary
interventions.
European
Journal
of
Cardiovascular
Nursing
,
22
(Supplement_1), zvad064-111.
11.
Karimov, B., Abidova, D., Muyassar, M., Uzakova, M., Orziev, D., Ubaydullaev, S., &
Naezulloeva, D. (2022, June). Plasma B-type natriuretic peptide in patients with coronary artery
disease and metabolic syndrome. In EUROPEAN JOURNAL OF CLINICAL INVESTIGATION
(Vol. 52). 111 RIVER ST, HOBOKEN 07030-5774, NJ USA: WILEY.
12.
Nozimjon o’g’li, S. S., & Ilhomjon o’g’li, A. N. INFORMATION ABOUT THE
STRUCTURE OF THE MEMBRANE OF EPITHELIAL TISSUE AND GLANDS.
13.
Yusup o‘g’li, M. I. (2022). Mustaqil ta’limni blended learning texnologiyasi asosida tashkil
etish. FAN, TA'LIM VA AMALIYOTNING INTEGRASIYASI, 126-131.
14.
Yusup o‘g‘li, M. I. (2024). OLIY TА’LIM MUАSSАLАRIDА INKLYUZIV TА’LIMNI
RIVOJLАNTIRISH: MUАMMO VА YECHIMLАR. FAN, TA'LIM VA AMALIYOTNING
INTEGRASIYASI, 5(1), 1-10.
15.
Akiljanovna, M.L., 2024. THE COURSE OF PSORIASIS IN YOUNG AND OLD
CHILDREN. Ethiopian International Journal of Multidisciplinary Research, 11(03), pp.205-207.
16.
Nozimjon o’g’li, S. S., & Makhmudovich, A. H. (2024). The Most Effective Drugs in the
Treatment of Myocarditis Disease.
Health & Medical Sciences
,
1
(2), 6-6.
17.
Nasirova, G. A., & Mukhamedova, M. G. (2023). Chronic heart failure and COVID-
19.
International Journal of Scientific Research Updates
,
5
(1), 138-42.
