成人輸尿管囊腫之內視鏡治療：病例系列與文獻回顧

高偉鈞、蘇家震、劉建良、李高漢、黃冠華

奇美醫療財團法人奇美醫院 外科部 泌尿科

Endoscopic management of ureterocele in adults: 

a series of 11 cases and literature review

Wei-Chun Kao, Chia-Cheng Su, Chien-Liang Liu, Kau-Han Lee, Steven K. Huang

Division of Urology, Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan

Purpose: Ureterocele in adults is an uncommon urological anomaly that may cause obstruction, stone formation, or infection. Endoscopic excision has been widely adopted as a minimally invasive treatment, but postoperative vesicoureteral reflux (VUR) remains a concern. This study aimed to evaluate the efficacy and safety of endoscopic excision for adult ureterocele and to determine the incidence of VUR.

Materials and Methods: We retrospectively reviewed 11 adult patients with ureterocele treated at our institution between December 2015 and January 2025. The cohort included 5 men and 6 women with a mean age of 40.2 years. Ureterocele involved a single ureteral system in 8 cases and a duplicated system in 3 cases. All underwent transurethral endoscopic excision. Five patients had ureterocele-associated calculi, which were managed concurrently with endoscopic lithotripsy.

Results: All patients had uneventful postoperative courses, with range of ureterocele size from 1-4 cm and mean hospitalization of 33.8 hours. Flank pain and lower urinary tract symptoms were resolved. Among 5 patients with calculi, only 1 had residual fragments. De novo VUR occurred in one patient, but resolved spontaneously during follow-up.

Conclusions: Endoscopic excision is a safe and effective first-line treatment for adult ureterocele without significant upper urinary tract dilatation. This minimally invasive approach achieves decompression and simultaneous stone management with minimal morbidity. VUR is the main complication but is typically low-grade and self-limiting. Routine radiological follow-up is recommended.