Outcome of suprapubic transvesical grasper-assisted endoscopic drainage of ureterocele in children: a single-center experience

Abstract Purpose Ureterocele is a congenital malformation characterized by cystic dilatation of the distal ureter. Endoscopic decompression is the standard initial treatment in symptomatic cases. This study evaluates the efficacy and safety of the suprapubic transvesical grasper-assisted technique (SATUP) for endoscopic drainage of ureterocele in children . Materials and methods A retrospective review was conducted of pediatric patients who underwent SATUP drainage for ureterocele between 2016 and 2022. Patients were followed for a mean duration of 22 months (18 till 48 months). Outcomes assessed included improvement in hydronephrosis, development of vesicoureteral reflux (VUR), incidence of urinary tract infections (UTIs), and need for re-intervention. Procedural safety was evaluated by assessing operative time and complications, such as urinary leakage, bleeding, or bladder perforation. Results Nineteen ureterocele moieties in 16 patients were treated using the SATUP technique. Transurethral incision was performed at a mean age of 16 months in single-system ureteroceles and 7 months in duplex systems. Hydronephrosis improved in 83% of single-system and 68% of duplex-system cases. De novo reflux developed in 14% and 53% of these groups, respectively. No single-system cases required further surgery. Two patients with bilateral duplex-system ureteroceles underwent bilateral ureteric reimplantation 36 months post-procedure due to recurrent UTIs. Mean operative time was 25 min, and no procedure-related complications, such as bladder wall hematoma or urinary leakage were reported. Conclusions SATUP appears to be a safe and effective adjunct to conventional endoscopic treatment for pediatric ureterocele, offering improved surgical control without added morbidity.