Cystoscopic Treatments for Congenital Kidney & Urinary Tract Problems

Some conditions, such as vesicoureteral reflux, may become less severe as a child grows. Doctors at Hassenfeld Children’s Hospital at NYU Langone may prescribe antibiotics for children who develop urinary tract infections as a result of a congenital kidney problem.

When further treatment is needed, our doctors can perform minimally invasive procedures using a cystoscope—a hollow tube with a fiber-optic camera attached to one end—to correct some congenital kidney or lower urinary tract problems by improving the flow of urine.

Before any cystoscopic procedure, an anesthesiologist administers a short-acting sedative. A urologist or surgeon then inserts the cystoscope into the urinary tract via the urethra—the tube that carries urine out of the bladder. This enables the doctor to view any blockages in the urinary tract. The doctor can pass surgical tools and other treatments through the cystoscope to alleviate blockages.

Cystoscopic Treatment of Vesicoureteral Reflux

Children with moderate or severe vesicoureteral reflux that does not improve, or those who have breakthrough urinary tract infections even after using preventive antibiotics, may require a minimally invasive procedure to improve the flow of urine. In this procedure, a urologist or surgeon inserts a cystoscope into the urethra and deposits a clear gel beneath the opening of the ureter. Over time, a capsule forms around the gel. This capsule helps to attach the ureter and the bladder muscle, preventing reflux.

Most children return home two hours after the procedure. Three months later, the doctor may perform a voiding cystourethrogram (VCUG) to determine if the reflux has resolved completely.

Posterior Urethral Valve Ablation

In a posterior urethral valve ablation, the doctor inserts surgical instruments through the cystoscope and removes extra tissue in the urethra that is blocking the flow of urine. Our doctors perform a VCUG test before your child leaves the hospital to make sure that he or she is emptying of the bladder completely. Most children return home in two days after posterior urethral valve ablation.

About two weeks after the procedure, the doctor performs a kidney ultrasound and laboratory tests to monitor kidney and bladder dilation and function.

Ureterocele Puncture

In ureterocele puncture, the doctor uses a cystoscope with a surgical instrument through it to puncture, or decompress, some ureteroceles, relieving the blockage. One to two weeks later, the doctor may order a kidney ultrasound to see if the procedure was effective in decompressing the ureterocele and reducing the blockage.

Additional treatment with surgery may be needed if urinary reflux develops after this procedure has been performed.