Technique Using a Percutaneous Nephroscope and Nephroscopic Scissors Transurethrally for Treatment of Complicated Orthotopic Ureterocele in Adult Women

ObjectiveTo present an endoscopic technique for the decompression of complicated orthotopic ureterocele in adult women.MethodsFive women with complicated orthotopic ureterocele were evaluated in the present study. The ureterocele was complicated by stones in 2 patients and urinary tract infection in 4. An endoscopic technique was used for the treatment of these ureteroceles. A 26F rigid nephroscope was placed into the bladder. When the ureterocele was seen in the bladder, the nephroscopic scissors was advanced through the nephroscopic channel to the ureterocele. A puncture was made on the anterior wall of the ureterocele using the nephroscopic scissors. Next, a ureteral catheter was introduced to puncture the ureterocele. Next, a window approximately 5-10 mm in diameter was opened on the wall of the ureterocele using the nephroscopic scissors. Finally, a double-J stent and urethral catheter were placed. The stones were fragmented using a pneumatic lithotripter. All the patients were evaluated with urinalysis, urine culture, ultrasonography, and voiding cystourethrography at the third month postoperatively.ResultsThe mean procedure time was 18.4 minutes. No complication was observed during the procedure, except for mild hematuria. The mean postoperative hospital stay was 19.8 hours. All patients with stones were stone free after the procedure. No cases of postoperative urinary tract infection developed. None of these patients had de novo reflux or obstruction at 3 months postoperatively.ConclusionThis technique could be an alternative treatment option for decompression of complicated orthotopic ureterocele in adult women.