Ureterocele

Ureterocele

Definition

A congenital dilation of the distal portion of the ureter, frequently but not exclusively associated with ureteral duplication.

Clinical Image & Complications

Large ureteroceles can cause acute urinary obstruction, hydronephrosis, painful vaginal mass, hematuria, dysuria and urinary tract infections. A chronic obstruction may lead to loss of kidney function.

Ureterocele; a cyst within the bladder.

Pathogenesis

Abnormal development between the accessory ureteral bud and urogenital sinus or a defect in the muscular wall of the ureter.

Diagnosis

On ultrasound the ureterocele within the bladder appears like a cyst within a cyst. During live examination the ureterocele can be seen to inflate and deflate.

Traditionally the diagnosis of an ureterocele was made with an intravenous pyelogram (cobra head sign).

An asymptomatic ureterocele. Notice how the cystic finding within the bladder inflates and deflates.
The same patient as above. In case of doubt it is simple to just follow the course of the ipsilateral ureter and it will lead you to the ureterocele. Notice that this patient has bilateral ureteroceles.

Management

Usually conservative follow-up. Transurethral resection in case of serious symptoms.

You might also find interesting other articles on pelvic floor ultrasound:

Bibliography

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