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]
In the present case, CT scan confirmed the absence of urolithiasis. [hindawi.com]
We present five proved cases of ureterocele demonstrating the typical radiographic findings. [pubs.rsna.org]
Entire Body System
- Collapse
A ureterocele mass will collapse by merely incising its dome in a longitudinal manner for a distance of 2 to 4 mm. This effectively relieves the ureteral obstruction and is the most important step in the therapy of any existing urinary infection. [pediatrics.aappublications.org]
Fluoroscopy IVP Detectable findings include: filling defect in the bladder ( cobra head sign ) which may be distended, collapsed or even everted radiolucent halo effect an everted ureterocele will appear like a bladder diverticulum MCUG Voiding cystourethrogram [radiopaedia.org]
The bladder was partially filled at low pressure (about 30% of the maximum capacity) to avoid that the UTC could collapse backwards. [frontiersin.org]
- Sepsis
While it isn't common, the potentially life-threatening complication, called sepsis, can happen to infants, children, or adults. [verywellhealth.com]
[…] needed] 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]
One patient developed postoperative sepsis. All patients were reviewed clinically and radiologically at 3 months and at 6 months. Satisfactory results were obtained in every case with no residual stones and resolution of low back pain. [pubmed.ncbi.nlm.nih.gov]
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]
- Severe Pain
Severe pain made walking impossible. He did not report any dysuria or obstructive lower urinary tract symptoms. [iranjradiol.com]
An indwelling urethral catheter was placed to reduce the prolapsed ureterocele, decompress the bladder, and control her severe pain. Subsequently, she underwent the planned endoscopic procedure. [hindawi.com]
Gastrointestinal
- Failure to Thrive
Symptoms can include:[citation needed] 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 [en.wikipedia.org]
In young infants, failure to thrive or urinary tract infection may be the first sign of a symptomatic ureterocele. [emedicine.medscape.com]
The most common symptoms are: urinary tract infection, failure to thrive, abdominal pain, hematuria. [eurorad.org]
- Abdominal Tenderness
These symptoms could include: Pain or burning when urinating ( dysuria ) Urine that smells bad Having to urinate frequently/being woken up at night to urinate Blood in urine ( hematuria ) Abdominal, flank, and back pain (which may be cyclic) Abdominal [verywellhealth.com]
Flank tenderness often accompanies the abdominal findings. In infants, an abdominal mass due to hydronephrosis may be noted by transillumination in a dark room. [emedicine.medscape.com]
Symptomatic ureteroceles with hydronephrosis also manifest as signs of abdominal tenderness to palpation. [clinmedjournals.org]
- Constipation
He claims normal bowel habits, however he denies dyspepsia, constipation and indigestion, his systemic review was unremarkable, patient denies diabetes mellitus and hypertension, he was not commenced on regular medications apart from paracetamol for simple [casereports.in]
- Lower Abdominal Pain
While the patient was waiting for her elective surgery, she presented to the emergency department in acute urinary retention in addition to significant lower abdominal pain. [hindawi.com]
Eyes
- Prolapse
Keywords: Endoscopic resection, prolapse, ureterocele, vulvar mass How to cite this article: Campobasso D, Lanzi A, Pozzoli GL, Frattini A. Prolapsed ureterocele in an adult woman after endoscopic incision. [urologyannals.com]
Intravesical ureterocele • The uretercele prolapses into: • The bladder neck (may cause bladder neck obstruction) • The urethra (may emerge from the urethral orifice). Prolapsing (extravesical) ureterocele 7. Prolapsing ureterocele 8. [slideshare.net]
Urinary retention secondary to prolapsing ureteroceles in adults has been reported in only seven cases. All of these occurred with unilateral prolapse of a single-system ureterocele [3–9]. [hindawi.com]
Prolapse of a single-system ureterocele causing urinary retention in an adult woman. Int Urogynecol J. 2013; 24 :1761–3. [ PubMed ] [ Google Scholar ] 6. Scovell JM, Chan RC, Khavari R. [ncbi.nlm.nih.gov]
Depending on the size and position of a ureterocele, they may prolapse into the ureter causing complete bladder obstruction. [radiopaedia.org]
Musculoskeletal
- Back Pain
The clinical features were dominated by low back pain. The diagnosis of ureterocele was based on intravenous urography in 19 patients and was discovered on endoscopy in one patient. [pubmed.ncbi.nlm.nih.gov]
Usually there are no symptoms that accompany an ureterocele, but some patients experience: Flank or back pain Urinary tract infection Fever Painful urination Foul-smelling urine Abdominal pain Blood in the urine (hematuria) Excessive urination How is [childrensnational.org]
Symptoms Symptoms include: Abdominal pain Back pain that may be only on one side Severe side (flank) pain and spasms that may reach to the groin, genitals, and thigh Blood in the urine Burning pain while urinating ( dysuria ) Fever Foul-smelling urine [nicklauschildrens.org]
When symptoms do occur, they may include: Abdominal pain Back pain that may be only on one side Severe side (flank) pain and spasms that may reach to the groin, genitals, and thigh Blood in the urine Burning pain while urinating (dysuria) Fever Difficulty [medlineplus.gov]
- Low Back Pain
The clinical features were dominated by low back pain. The diagnosis of ureterocele was based on intravenous urography in 19 patients and was discovered on endoscopy in one patient. [pubmed.ncbi.nlm.nih.gov]
Here, we report on the case of a 71-year-old male who initially presented with haematuria and low back pain and who then underwent transurethral resection for an intraureterocele tumour. Pathology confirmed urothelial carcinoma. [ecancer.org]
The clinical features were dominated by low back pain. The ureterocele affected a single ureter in 16 cases (80%) and a duplex ureter at the expense of the upper renal segment in 4 cases. [clinmedjournals.org]
Neurologic
- Confusion
The signs and symptoms of ureterocele in the latter two forms can easily be confused with other medical conditions. [en.wikipedia.org]
The bullous edema surrounding an intravesical ureterocele containing calculus such as this case can mimic bladder tumors and confuse the less experienced cystoscopist. CONFLICT OF INTEREST None declared. REFERENCES 1. [scielo.br]
Nevertheless, the term ‘simple’ was not accepted because of the confusion concerning single‐system ectopic ureteroceles and duplex intravesical ureteroceles [ 2 ]. [onlinelibrary.wiley.com]
These numerous classifications and terminologies are confusing. They are neither very clear nor helpful in guiding management decisions. [archintsurg.org]
The signs and symptoms of ureteroceles in the latter two forms can easily be confused with other medical conditions. [clinmedjournals.org]
Urogenital
- Urinary Retention
Presenting symptoms vary greatly but urinary tract infections remain the most common [2]. Urinary retention secondary to prolapsing ureteroceles in adults has been reported in only seven cases. [hindawi.com]
Ureterocele and stone were the main findings in girls and boys with acute urinary retention, respectively, and urinary retention in boys was twice as prevalent as that in girls [86]. [clinmedjournals.org]
Prolapse of a single-system ureterocele causing urinary retention in an adult woman. Int Urogynecol J. 2013; 24 :1761–3. [ PubMed ] [ Google Scholar ] 6. Scovell JM, Chan RC, Khavari R. [ncbi.nlm.nih.gov]
The most common symptoms of presentation differ from urinary retention to vulvar mass. In seven cases, which have been published between 1979 and 1994, we did not find any information about management and outcomes. [urologyannals.com]
- Kidney Failure
These infections can affect the bladder or kidney. Kidney damage can happen if they are not treated or happen often. This could lead to kidney failure and, over time, a kidney transplant may be needed. Preventative antibiotics can help with this. [nationwidechildrens.org]
However, damage to the kidney may be permanent, especially if the condition doesn't go away. Kidney failure is uncommon. The other kidney will most often work normally. [nicklauschildrens.org]
However, damage to the kidney may be permanent if the condition doesn't go away. Kidney failure is uncommon. The other kidney will most often work normally. [medlineplus.gov]
However, damage to the kidney may be permanent, especially if the condition doesnt go away. Kidney failure is uncommon because the other kidney usually continues to work as normal. [indiatoday.in]
- Cloudy Urine
He was admitted to the hospital with complaints of miction pain, cloudy urine and fever attack. He had had pain at voiding from time to time during the past 10 years. The prostate was swollen, edematous and tender. [clinmedjournals.org]
- Urinary Urgency
Urinary stasis in the dilated distal segment often lends to urinary infection and stone formation; precluding the most common presenting symptoms of dysuria, urgency, and recurrent urinary infections. [scielo.br]
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]
Sections Ureterocele Overview Practice Essentials Relevant Anatomy Pathophysiology Etiology Epidemiology Prognosis Show All Presentation History Physical Examination Show All Workup Laboratory Studies Imaging Studies Procedures Histologic Findings Show [emedicine.medscape.com]
Urine
- 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]
Serum
- Hyperammonemia
The hyperammonemia was most likely caused by excessive absorption of ammonia produced by Proteus mirabilis in the obstructed urinary tract [45]. [clinmedjournals.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]
The treatment was mainly by open method (70%), while the rest had endoscopic treatment. All the patients did well and there were no significant perioperative complications. [archintsurg.org]
All of our children who underwent endoscopic treatment had DJ stents in place. The DJ stent was left in place for 3-4 weeks. [jiaps.com]
Cooper C.S, Kim E.D, Ureterocele treatment and mangement, Medscape, http://emedicine.medscape.com/article/451105-treatment#a1127. 2. [diagnosticimaging.com]
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]
However, the prognosis (outlook) for a ureterocele is good. A ureterocele can be treated and your child can go on to live a normal life. Treatment is also possible if the defect is not discovered until adulthood. [my.clevelandclinic.org]
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]
Ultrasonographic findings are relatively specific for ureteroceles, because the other etiologies of a cyst within a cyst are relatively rare. [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]
Epidemiology
Epidemiology Ureteroceles occur in approximately 1 in every 4000 children and occur most commonly in whites. [2] Females are affected 4-7 times more often than males. [emedicine.medscape.com]
Pathophysiology
The ureterovesical junction may be divided into 3 sections, as follows: Terminal portion (juxtavesical ureter) Intramural portion Submucosal portion (lying under the mucosa of the bladder) Pathophysiology It is important to make a distinction between [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
Antibiotics Antibiotics are used to fight bacteria and prevent kidney infection. A child with a possible urine block or urine reflux may be given antibiotics to prevent infections until the defect is corrected. [urologyhealth.org]
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]
Can ureteroceles be prevented? No. Ureteroceles are congenital conditions. However, the urinary tract infections that are often associated with ureteroceles may be prevented with antibiotics. [childrenshospital.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. [nicklauschildrens.org]