Presentation
Seven (87.5%) patients presented with prenatal detection of hydronephrosis and ureterocele, one (12.5%) patient presented with a febrile UTI. All patients were on antibiotic prophylaxis throughout the surgery. [liebertpub.com]
Results Presentations Urinary tract infection; urosepsis: Urinary tract infection is usually the most common postnatal presentation of ureterocle, patients presented with cloudy urine, urinary pain, and fever [ 42, 43 ]. [clinmedjournals.org]
We present five proved cases of ureterocele demonstrating the typical radiographic findings. [pubs.rsna.org]
Conclusion Bilateral intravesical, simple ureterocele in an adult male with normal upper tract development is a rare clinical presentation. In general, patients presented with ureterocele may exhibit variety of clinical presentations. [casereports.in]
We also review the varied presentations and management of obstructing ureteroceles in adults who have presented at our institution. [ncbi.nlm.nih.gov]
Entire Body System
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Sepsis
While it isn't common, the potentially life-threatening complication, called sepsis, can happen to infants, children, or adults. [verywellhealth.com]
[…] include: Frequent urinary tract infections Pyelonephritis Obstructive voiding symptoms Urinary retention Failure to thrive Hematuria Cyclic abdominal pain Urolithiasis Cobra head sign is seen in radiography In females: salpingitis, hydrosalpinx with sepsis [en.wikipedia.org]
Follow-Up Children were discharged within 48 h from surgery, except if severe UTIs or urinary sepsis were present at the hospital admission. [frontiersin.org]
Nevertheless, most urological investigators agree that endoscopic puncture of an ectopic ureterocele is indicated mainly for uncontrolled sepsis and azotaemia with BOO with or with no ureterocele prolapse. [onlinelibrary.wiley.com]
One study report on a boy with ureteroceles that obstructed the bladder outlet and ureters, who presented with sepsis and hyperammonemia despite normal liver function. [clinmedjournals.org]
Gastrointestinal
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Recurrent Abdominal Pain
There is no characteristic clinical picture caused by this condition, but fever, pyuria and recurrent abdominal pain are often present in children. [8] The main clinical presentation in this patient was recurrent abdominal pain. [wajradiology.org]
Urogenital
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Salpingitis
Symptoms can include: Frequent urinary tract infections Pyelonephritis Obstructive voiding symptoms Urinary retention Failure to thrive Hematuria Cyclic abdominal pain Urolithiasis Cobra head sign is seen in radiography In females: salpingitis, hydrosalpinx [en.wikipedia.org]
Workup
Once the UTI is diagnosed, further radiology workup can identify the ureterocele. Your child may be placed on a low dose of antibiotics to inhibit the growth of bacteria and prevent further UTIs. This is called antibiotic prophylaxis. [chop.edu]
Although patient refused diagnostic cystoscopy, radiological workup confirms the intravesical location of ureterocele in our patient which is the rare variant [ 3, 4 ]. Clinical findings are variable. [casereports.in]
Urine
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Pyuria
The outstanding symptoms are referable to pyuria, which appears in most cases. There may be abdominal or flank pain from the ureteric obstruction. [pediatrics.aappublications.org]
Her urinalysis with microscopy was positive for pyuria and bacteriuria. [ncbi.nlm.nih.gov]
Case 1 A 1-year-old boy presented in the casuality with high fever, altered sensorium, pyuria and in azotemia. He had a history of recurrent UTIs. On examination, his bladder was palpable and urine obtained on catheterization was full of pus cells. [jiaps.com]
There is no characteristic clinical picture caused by this condition, but fever, pyuria and recurrent abdominal pain are often present in children. [8] The main clinical presentation in this patient was recurrent abdominal pain. [wajradiology.org]
The entire urine specimen from patients with either flank pain and/or painful urination had pyuria, and a positive culture of bacteria was obtained in 80% percent of them. [archintsurg.org]
Treatment
Nevertheless, the general goals of ureterocele treatment can be applied to all patients. [onlinelibrary.wiley.com]
[…] of the nonfunctioning moiety of duplex kidney in adults: A case series. 38 Singh M...Sankhwar S 31098429 2019 11 Technical challenges of endoscopic treatment for vesicoureteral reflux after Cohen reimplantation. 38 Carrillo Arroyo I...Cabezali Barbancho [malacards.org]
Published October 7, 2019 Clinical Outcomes of the Upper Urinary Tract After Ureteral Clipping for the Treatment of Low or Non-Functioning Renal Moieties. [urotoday.com]
Inclusion criteria covered patients whose treatment was completed in our surgical departments. [ncbi.nlm.nih.gov]
Treatment of the ureterocele often depends on how severe the condition is. A small ureterocele may not need treatment if the kidney is working well enough. In other cases, a child may need surgery. [stlouischildrens.org]
Prognosis
The prognosis of ureterocoeles is related to the degree of associated reflux or obstruction. [radiopaedia.org]
Ultrasonographic Findings Radiographic Findings CT Findings MR Findings Imaging Recommendations General Features Staging, Grading, & Classification Gross Pathologic & Surgical Features Microscopic Features Presentation Demographics Natural History & Prognosis [app.statdx.com]
Outlook (Prognosis) The outcome varies. The damage may be temporary if the blockage can be cured. However, damage to the kidney may be permanent, especially if the condition doesn't go away. Kidney failure is uncommon. [nicklauschildrens.org]
Post natal Day 1 USG,KUB ,MCU showed a very large ureterocele with bilateral hydronephrosis Day 2 DMSA scan done as a baseline for future prognosis and it revealed a normal functioning right kidney and slight impaired cortical uptake in left kidney (fig [fetalmedicineindia.in]
Etiology
Intravesical cystic dilation or septa within the bladder (which represent ureterocele walls) suggest that the etiology of the hydronephrosis may be an ureterocele. [ijri.org]
Etiology • Delayed canalization of Chwalla membrane during embryogenesis which causes obstruction of the ureteric orifice. • (Chwalla membrane is a primitive membrane that separates the ureteric bud from the developing urogenital sinus). [slideshare.net]
Etiology The precise embryologic etiology of the ureterocele remains unknown. [emedicine.medscape.com]
Click here to view Therefore, for final confirmation of etiology, magnetic resonance imaging (MRI) was performed on a 1.5-T Phillips Achieva scanner. [astrocyte.in]
There is debate about its etiology; while it is commonly accepted that it is congenital, some believe the adult type is acquired. [archintsurg.org]
Epidemiology
Epidemiology Frequency Ureteroceles occur in approximately 1 in every 4000 children and occur most commonly in whites. Females are affected 4-7 times more often than males. [emedicine.medscape.com]
Pathophysiology
Pathophysiology It is important to make a distinction between orthotopic and ectopic ureteroceles since therapeutic options and outcomes differ between these two clinical entities. [emedicine.medscape.com]
In 1968, Stephens [ 3 ] developed a pathophysiological classification which divided ureteroceles according to the size and location of the ureteric orifice into four categories: • Stenotic, narrow orifice within the bladder; • Sphincteric, wide orifice [onlinelibrary.wiley.com]
Prevention
Outcomes included relief of obstruction, prevention of infection/reflux, and need for subsequent surgery. [sjkdt.org]
The cause of ureteroceles is unknown and there is no known prevention for this condition. Who gets ureterocele? Ureteroceles run in families, so there is a genetic component. [childrenscolorado.org]
The swollen area prevents urine from moving freely into the bladder. The urine collects in the ureter and stretches its walls. It expands like a water balloon. A ureterocele can also cause urine to flow backward from the bladder to the kidney. [medlineplus.gov]
The swollen area prevents urine from moving freely into the bladder. The urine collects in the ureter and stretches its walls, blowing it up like a water balloon. A ureterocele can also cause urine to flow backward from the bladder to the kidney. [indiatoday.in]