Ureterocele
Definition
A ureterocele is a swelling at the bottom of one of the tubes (ureters) that carry urine from the kidney to the bladder. The swollen area can block urine flow.
A ureterocele is a birth defect.
Causes
A ureterocele occurs in the lower part of the ureter, where the tube enters the bladder. 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. This is called reflux.
Ureteroceles occur in about 1 in 500 to 1 in 4,000 people. Ureteroceles are equally common in both the left and right ureters.
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
- Frequent and urgent urination
- Lump (mass) in the abdomen that can be felt
- Ureterocele tissue falls down (prolapse) through the female urethra and into the vagina
- Urinary incontinence
- Urinary tract infection
Exams and Tests
Large ureteroceles are often diagnosed earlier than smaller ones. A ureterocele may be discovered in a pregnancy ultrasound before the baby is born.
Some people with ureteroceles do not know they have the condition. Often, the problem is found later in life due to kidney stones or infection.
A urinalysis may reveal blood in the urine or signs of urinary tract infection.
The following tests may be done:
- Abdominal ultrasound
- CT scan of the abdomen
- Cystoscopy (examination of the inside of the bladder)
- Pyelogram
- Radionuclide renal scan
- Voiding cystourethrogram
Blood pressure may be high if there is kidney damage.
Treatment
Antibiotics are often given to prevent further infections until surgery can be done.
The goal of treatment is to eliminate of the blockage. Drains placed in the ureter or renal area (stents) may provide short-term relief of symptoms.
Surgery to repair the ureterocele cures the condition in most cases. Surgery involves making a cut into the ureterocele or removing the ureterocele and reattaching the ureter to the bladder. The type of surgery depends on your age, overall health, and extent of the blockage.
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. The other kidney will most often work normally.
Possible Complications
Complications may include:
- Long term bladder damage (incontinence/urinary retention)
- Long term kidney damage, including loss of function in one kidney
- Urinary tract infection that keeps coming back
When to Contact a Medical Professional
Call your health care provider if you have symptoms of ureterocele.
References
Guay-Woodford LM. Hereditary nephropathies and developmental abnormalities of the urinary tract. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 130.
Peters CA, Schlussel RN, Mendelsohn C. Ectopic ureter, ureterocele, and ureteral anomalies. In: Wein AJ, ed. Campbell-Walsh Urology. 10th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 116.