Document Detail

Endoscopic treatment of vesicovasal and vesicoureteral reflux in infants with persisting mesonephric duct.
MedLine Citation:
PMID:  17085187     Owner:  NLM     Status:  MEDLINE    
PURPOSE: We present a minimally invasive endoscopic approach for the treatment of persisting mesonephric duct in male infants. MATERIALS AND METHODS: Five male infants 2 to 8 months old were referred with a history of recurrent sepsis, epididymo-orchitis and anorectal malformation that was treated elsewhere with initial colostomy. All infants had edematous unilateral testes, fever and poor feeding. Urine and blood cultures yielded the same microorganisms. All infections occurred while the infants were on regimens of prophylactic antibiotics. Comprehensive urological evaluations confirmed ipsilateral renal agenesis, sacral hypoplasia (3 patients), high anorectal malformation, and vesicovasal and vesicoureteral reflux. RESULTS: All 5 infants underwent urethrocystoscopy under general anesthesia. The ectopic persisting mesonephric duct entered the bladder neck and proximal prostatic urethra. Injection of 0.4 to 0.7 ml Urocol, used as a bulking agent, was administered submucosally at the opening of the persisting mesonephric duct. In 1 patient the orifice of the anomalous duct was not found during urethrocystoscopy, and ipsilateral vas ligation by titanium clips was performed. The results in the remaining 4 patients were excellent, and no further episodes of epididymitis were observed during a mean followup of 30 months. CONCLUSIONS: The diagnosis of persisting mesonephric duct should be considered in a male child with anorectal anomalies and recurrent epididymo-orchitis, and can be confirmed by radiological studies and cystoscopy. Endoscopic treatment of this anomaly should be considered first line therapy in these patients. However, surgical intervention is mandatory for children not responding to the procedure.
Abdol-Mohammad Kajbafzadeh; Seyedmehdi Payabvash
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of urology     Volume:  176     ISSN:  0022-5347     ISO Abbreviation:  J. Urol.     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2006-11-06     Completed Date:  2006-12-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2657-62     Citation Subset:  AIM; IM    
Department of Urology, Pediatric Urology Research Center, Children's Hospital Medical Center, Tehran University of Medical Sciences, No. 36 7th St., Saadat-Abad, Ave. Tehran 19987, Iran.
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MeSH Terms
Drug Carriers / administration & dosage
Drug Combinations
Epididymitis / etiology,  surgery
Glucosamine / administration & dosage
Orchitis / etiology,  surgery
Polyethylene Glycols / administration & dosage
Prospective Studies
Ureter / abnormalities*
Urologic Surgical Procedures, Male*
Vas Deferens / abnormalities*
Vesico-Ureteral Reflux / surgery*
Reg. No./Substance:
0/Drug Carriers; 0/Drug Combinations; 0/Polyethylene Glycols; 3416-24-8/Glucosamine

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