Outcome analysis of prenatally detected ureteroceles associated with multicystic dysplasia.

Abstract

We assessed the outcome of a nonoperative approach in infants with prenatally detected ureteroceles associated with multicystic dysplasia. A retrospective analysis of all infants with ureteroceles referred for evaluation of prenatally hydronephrosis was conducted. Ultrasound, cystogram and scintigraphy findings were tabulated. Clinical outcomes including infections and the need for surgical intervention were assessed. We identified 5 female and 3 male infants with prenatally detected ureteroceles and associated multicystic dysplasia. There were 4 cases with renal duplication and 4 with single systems. All infants were treated expectantly. One infant had a single urinary tract infection. The multicystic dysplastic moiety involuted by age 18 months in all children. The ureterocele collapsed in 3 children and remained stable in the remainder. None of the children required surgical intervention with a median and mean followup of 36 months (range 14 to 54). We identified a subset of prenatally diagnosed ureteroceles that had a benign clinical course and did not require surgical intervention with available followup. Careful evaluation and interpretation of postnatal studies will allow identification and observational management of this unique subset of ureteroceles associated with multicystic dysplasia and absence of hydroureteronephrosis.