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Ureterocele

Incontinence - ureterocele

 

A ureterocele is a swelling at the bottom of one of the ureters. Ureters are the tubes 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. It is the part 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 people. This condition is equally common in both the left and right ureters.

 

Symptoms

 

Most people with ureteroceles do not have any symptoms. 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

Some other symptoms are:

  • 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

 

Exams and Tests

 

Large ureteroceles are often diagnosed earlier than smaller ones. It 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. Your surgeon may cut into the ureterocele. Another surgery may involve 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 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-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 128.

Peters CA, Mendelsohn C. Ectopic ureter, ureterocele, and ureteral anomalies. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016:chap 134.

 
  • Female urinary tract

    Female urinary tract - illustration

    The female and male urinary tracts are relatively the same except for the length of the urethra.

    Female urinary tract

    illustration

  • Male urinary tract

    Male urinary tract - illustration

    The male and female urinary tracts are relatively the same except for the length of the urethra.

    Male urinary tract

    illustration

  • Ureterocele

    Ureterocele - illustration

    A ureterocele is a congenital (from birth) disorder in which the ureter develops an out-pouching as it enters the bladder. Ureteroceles usually occur after frequent urinary tract infections. Treatment of the ureterocele usually involves the placement of a stent to relieve the obstruction and/or surgical repair.

    Ureterocele

    illustration

    • Female urinary tract

      Female urinary tract - illustration

      The female and male urinary tracts are relatively the same except for the length of the urethra.

      Female urinary tract

      illustration

    • Male urinary tract

      Male urinary tract - illustration

      The male and female urinary tracts are relatively the same except for the length of the urethra.

      Male urinary tract

      illustration

    • Ureterocele

      Ureterocele - illustration

      A ureterocele is a congenital (from birth) disorder in which the ureter develops an out-pouching as it enters the bladder. Ureteroceles usually occur after frequent urinary tract infections. Treatment of the ureterocele usually involves the placement of a stent to relieve the obstruction and/or surgical repair.

      Ureterocele

      illustration

    Tests for Ureterocele

     

       

      Review Date: 10/4/2016

      Reviewed By: Jennifer Sobol, DO, urologist with the Michigan Institute of Urology, West Bloomfield, MI. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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