Risk factors for recurrent urinary tract infections after endoscopic incision of ureterocele in infant

Abstract

Objectives Much dispute encompasses the treatment of ureterocele. Generally, in patients with ureterocele, endoscopic incision (EI) is recommended to prevent urinary tract infections (UTIs) or progressive hydronephrotic complications and preserve renal function. To clarify the impact of EI for ureterocele as an initial procedure, focusing on end points of postoperative recurrent febrile UTIs and need for second surgery. Patients and Methods: Between December 2006 and December 2019 primary EI was performed in 80 consecutive patients with ureterocele. We retrospectively investigated patient preoperative radiological and clinical data and postoperative radiological and clinical outcomes. Results All 80 patients who underwent EI were identified and included in our study, and EI was conducted at an average of 4.6 (IQR 2.5 to 8.5) months. Twenty-nine patients with ureterocele had postoperative recurrent febrile UTIs during the follow-up of 36 months, and 22 out of 29 patients were recommended secondary intervention. Initial recurrent febrile UTIs in most child occurred < 12 months after EI, the recurrent febrile UTIs-free rate after EI was 63.75%. The risk factor for recurrent febrile UTIs was VUR on postoperative VCUG, antibiotic prophylaxis treatment might be beneficial in preventing recurrent febrile UTIs after EI. Conclusion EI is optimal for instant ureterocele decompression, and it avoids a complete reconstruction in most patients. However, it is not a definitive approach in cases with postoperative VUR. Our study determined the critical period and risk factor for recurrent febrile UTIs after EI for the treatment of ureterocele.