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Concept
Ureterocele
Résumé
A ureterocele is a congenital abnormality found in the ureter. In this condition the distal ureter balloons at its opening into the bladder, forming a sac-like pouch. It is most often associated with a duplicated collection system, where two ureters drain their respective kidney instead of one. Simple ureterocele, where the condition involves only a single ureter, represents only twenty percent of cases.
Since the advent of the ultrasound, most ureteroceles are diagnosed prenatally. The pediatric and adult conditions are often found incidentally, i.e. through diagnostic imaging performed for unrelated reasons.
Intravesical Confined within the bladder
Ectopic Some part extends to the bladder neck or urethra
Stenotic Intravesical ureterocele with a narrow opening
Sphincteric Ectopic ureterocele with an orifice distal to the bladder neck
Sphincterostenotic Orifice is both stenotic and distal to the bladder neck
Cecoureterocele Ectopic ureterocele that extends into the urethra, but the orifice is in the bladder
The signs and symptoms of ureterocele in the latter two forms can easily be confused with other medical conditions. Symptoms can include:
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 or torsion. T.O. mass.
Many other complications arise from ureteroceles. Redundant collection systems are usually smaller in diameter than single, and predispose the patient to impassable kidney stones. The effective "bladder within a bladder" compounds this problem by increasing the collision of uric acid particles, the process by which uric acid stones are formed. Ureterocele is also associated with poor kidney function. It can cause frequent blockage of the ureter leading to serious kidney damage. In other cases, a small, upper portion of the kidney is congenitally non-functional. Though often benign, this problem can necessitate the removal of non-functioning parts.
Source officielle
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