Commentary on "Retrograde incision from orifice (RIO) technique for endoscopic incision of ureterocele: 15 years of outcomes".

Corona et al. [ [1] Corona L.E. Lai A. Meyer T. Rosoklija I. Berkowitz R. Liu D. et al. Retrograde incision from orifice (RIO) technique for endoscopic incision of ureterocele: 15 years of outcomes. J Pediatr Urol. 2023; 19: 85.e1-85.e8https://doi.org/10.1016/j.jpurol.2022.09.024 Abstract Full Text Full Text PDF Scopus (0) Google Scholar ] reported their surgical outcomes of endoscopic ureterocele incision using the retrograde incision from orifice (RIO) technique. As mentioned by the authors, successful decompression of the obstructive ureteroceles without complication and any need for subsequent secondary surgeries are of great importance. However, there are several points that we believe to be discussed on this subject. Retrograde incision from orifice (RIO) technique for endoscopic incision of ureterocele: 15 years of outcomesJournal of Pediatric UrologyVol. 19Issue 1PreviewManagement of obstructing ureterocele often includes endoscopic transurethral incision (TUI) that can be challenging secondary to uncertainty in anatomic landmarks with risk of serious complications. To this end, we innovated a technique using predictable landmarks that begins endoscopic incision at the ureterocele orifice and extends retrograde proximal to the bladder neck (Figure). Full-Text PDF Response to commentary re retrograde incision from orifice (RIO) technique for endoscopic incision of ureterocele: 15 years of outcomesJournal of Pediatric UrologyVol. 19Issue 5PreviewWe appreciate the authors' comments on our work detailing our retrograde incision from orifice (RIO) technique [1]. Our study compared 15 years of institutional outcomes for endoscopic management for obstructing ureterocele and found that RIO performed similarly to the more classical low transverse incision. The authors expressed doubt regarding the predictability of ureterocele landmarks, citing the <50% utilization of RIO at our institution. However, it is important to note that our study represents a diverse group of 11 surgeons with varied practice patterns and surgical approaches and not a single-surgeon experience. Full-Text PDF