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[Ureterocele in adults complicated with calculi: diagnostic and therapeutic features. Report of 20 cases].

STUDY OBJECTIVE
The authors study the various diagnostic and therapeutic aspects of adult ureterocele and evaluate the place of endoscopic treatment.


MATERIALS AND METHODS
This retrospective study was based on 20 cases of ureterocele in adults complicated by stones and observed between January 1990 and December 2001. This series consisted of 8 men and 12 women with a mean age of 48.3 years (range: 24-75 years). The clinical features were dominated by low back pain. The diagnosis of ureterocele was based on intravenous urography in 19 patients and was discovered on endoscopy in one patient. The ureterocele affected a single ureter in 16 cases (80%) and a duplex ureter at the expense of the upper renal segment in 4 cases. All patients were treated by endoscopic horizontal meatotomy with stone fragmentation and extraction. The mean operating time was 27 min (range: 18-58 min).


RESULTS
The postoperative course was uneventful in 19 patients. One patient developed postoperative sepsis. All patients were reviewed clinically and radiologically at 3 months and at 6 months. Satisfactory results were obtained in every case with no residual stones and resolution of low back pain. Only one patient presented vesicoureteric reflux which had resolved on the follow-up urethrocystography performed at 6 months.


CONCLUSION
Adult ureterocele complicated by stones is a well tolerated, rare entity that can often be easily diagnosed. Endoscopic meatotomy is easy to perform and gives good results. The associated stones constitute an additional argument in favour of endoscopic treatment.