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
- Pain
In this study, the presenting symptoms were flank pain and painful micturition, each occurring in 60% of the patients; four of the patients with flank pain also had painful urination. [archintsurg.org]
CASE REPORT Orthotopic ureterocele masquerading as a bladder tumor in a woman with pelvic pain David D. Thiel; Steven P. Petrou; Gregory A. [scielo.br]
Indian J Urol 2002;19:86-7 A 37-year-old male presented elsewhere with flank pain and an episode of haematuria; for which an ultrasonographic (US) examination was done. [indianjurol.com]
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]
- Fever
On examination, there was LLQ tenderness without rebound or guarding, no costovertebral angle tenderness, a normal external genitalia and a low grade fever. [iranjradiol.com]
[…] urinating Trouble urinating Pain above the pubic bone Blood in the urine Bad-smelling urine Nausea and vomiting Fever Chills Pain in the back or side below the ribs Tiredness The symptoms can seem like other health conditions. [stlouischildrens.org]
Symptoms of a UTI can include fever, need to urinate often, pain, and crying. A small ureterocele may not need treatment if the kidney is working well enough. In other cases, a child may need surgery. [stanfordchildrens.org]
When it does, a child may experience one or more of the following: Blood in the urine Burning sensation when urinating Fever Foul-smelling urine Lump in the abdomen Pain in the abdominal area Urinating more frequently than usual Urinary incontinence [childrens.com]
- Asymptomatic
The child is asymptomatic and is on yearly follow-up with ultrasound examination and blood pressure monitoring. [jiaps.com]
She was successfully treated with transurethral unroofing of her bilateral ureteroceles and she is currently asymptomatic. [hindawi.com]
After 24 months, she was asymptomatic with no history of renal colic or urinary tract infection (UTI). At the ultrasound examination, no right hydronephrosis was revealed. [urologyannals.com]
They remained asymptomatic and had stable upper urinary tracts on serial US, with a mean follow‐up of 2.3 years. [onlinelibrary.wiley.com]
Although cystoscopy was not done in our case, the asymptomatic presentation and stable renal function were the main criteria that warrant non-surgical approach. [casereports.in]
- Recurrent Urinary Tract Infection
Intravesical single system ureterocele usually presents in adults with flank pain, recurrent urinary tract infection (UTI) and haematuria. Sometimes they are detected serendipitously. [indianjurol.com]
If a ureterocele goes undetected on a prenatal ultrasound, it may not be seen until the child has recurrent urinary tract infections. [columbiadoctors.org]
If a ureterocele is not detected on a prenatal ultrasound, it may not be detected until the child has recurrent urinary tract infections. [vidanthealth.com]
If it’s not found then, it may not be discovered until your child has recurrent urinary tract infections. [childrenshospital.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]
Gastrointestinal
- 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]
Cyclical expansion and decompression of the renal pelvis manifests as intermittent abdominal pain in older children and adults. Ureterocele is a cause of abdominal pain or loin pain [60-63]. [clinmedjournals.org]
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]
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]
- Abdominal Mass
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]
Abdominal mass, abdominal distention, and vulvar mass: Ureterocele can be huge in size [52, 64,65] and present as abdominal mass [52], abdominal distention [59,65]. [clinmedjournals.org]
This condition is traditionally diagnosed after urologic investigations triggered by repetitive episodes of a severe urinary tract infection (UTI), although, occasionally, abdominal pain, urinary obstruction, palpable abdominal masses, and lithiasis have [wajradiology.org]
- Vomiting
[…] urinating Trouble urinating Pain above the pubic bone Blood in the urine Bad-smelling urine Nausea and vomiting Fever Chills Pain in the back or side below the ribs Tiredness The symptoms can seem like other health conditions. [stlouischildrens.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]
Musculoskeletal
- Osteoporosis
Past medical history was significant for osteoporosis and carpal tunnel repair. The patient was a hair dresser with a 30 pack-year smoking history. The patient denied any previous urologic history including calculi or hematuria. [scielo.br]
Neurologic
- Headache
[…] 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 headache [casereports.in]
Urogenital
- Pelvic Pain
CASE REPORT Orthotopic ureterocele masquerading as a bladder tumor in a woman with pelvic pain David D. Thiel; Steven P. Petrou; Gregory A. [scielo.br]
[…] symptoms in your child: a bulge in the abdomen area (if the ureterocele is obstructing urine from leaving the bladder) incontinence blood in the urine failure to thrive abdominal pain pelvic pain difficulty urinating recurrent UTIs Are there any other [childrenshospital.org]
Case Report A 20-year-old male patient presented to the urology department, with history of occasional right-sided pelvic pain and intermittent urinary obstruction. Blood investigations and urine routine microscopy reports were normal. [astrocyte.in]
Incont Pelvic Floor Dysfunct 2010;4:25. [Figure 1], [Figure 2] [wajradiology.org]
- Bladder Neck Obstruction
Incontinence of urine • Ectopic or prolpasing ureterocele Acute bladder neck obstruction Complications of ureterocele 13. Ureterocele stone 14. Ectopic ureterocele with bladder neck obstruction 15. [slideshare.net]
Secondary surgery is indicated upon failure of transurethral incision, persistent reflux and the presence of obstruction of ureters, and/or bladder neck or retained ureterocele. [casereports.in]
Obstruction of the bladder outlet is commonly caused by prolapse of the ureterocele into the urethra. A prolapsing ureterocele in a female patient may cause physical obstruction of the bladder neck. [clinmedjournals.org]
The choice of the more appropriate therapeutic modality depends on the following criteria: clinical patient's status (mainly febrile UTI or urinary sepsis), patient age, function of the upper pole, refluxing or obstructed ureter, bladder neck obstruction [frontiersin.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]
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]
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]