| Endoscopic treatment of vesicovasal and vesicoureteral reflux in infants with persisting mesonephric duct. | |
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MedLine Citation:
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PMID: 17085187 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Abdol-Mohammad Kajbafzadeh; Seyedmehdi Payabvash |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Journal of urology Volume: 176 ISSN: 0022-5347 ISO Abbreviation: J. Urol. Publication Date: 2006 Dec |
Date Detail:
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Created Date: 2006-11-06 Completed Date: 2006-12-20 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0376374 Medline TA: J Urol Country: United States |
Other Details:
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Languages: eng Pagination: 2657-62 Citation Subset: AIM; IM |
Affiliation:
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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. kajbafzd@sina.tums.ac.ir |
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| MeSH Terms | |
Descriptor/Qualifier:
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Cystoscopy Drug Carriers / administration & dosage Drug Combinations Endoscopy Epididymitis / etiology, surgery Glucosamine / administration & dosage Humans Infant Injections Male Orchitis / etiology, surgery Polyethylene Glycols / administration & dosage Prospective Studies Recurrence Ureter / abnormalities* Urologic Surgical Procedures, Male* Vas Deferens / abnormalities* Vesico-Ureteral Reflux / surgery* |
| Chemical | |
Reg. No./Substance:
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0/Drug Carriers; 0/Drug Combinations; 0/Polyethylene Glycols; 3416-24-8/Glucosamine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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