A ureterocele is an abnormality of the bladder. The medical condition may also be referred to as ureteroceles. This is often characterized by a ballooning of the distal ureter where it connects to the bladder. Ballooning creates a sac that can collect urine instead of passing it into the bladder.
In many cases ureterocele occurs when two ureters are draining one kidney into the bladder. Only 20% of all cases occur in patients with one ureter. These cases are referred to as simple ureteroceles. About one out of every 4,000 people is diagnosed with ureteroceles, and 80% of these patients are female.
Ureterocele is a congenital condition, which means infants are usually born with the abnormality. In some cases, the condition may be diagnosed in utero with ultrasound. If symptoms, such as frequent urinary tract infections, occur during childhood or adult years, and no previous diagnosis was made, magnetic resonance imaging (MRI) or computed tomography (CT) can be used for diagnosis.
There are six classifications of ureteroceles, including intravesical, ectopic, and stenotic. The remaining three classifications are sphincteric, sphincterostenotic, and cecoureterocele.
- Intravesical — Ureterocele limited to within the bladder.
- Ectopic — May extend outside of the bladder to the urethra and bladder neck.
- Stenotic — Limited to within the bladder but characterized with a narrow opening.
- Sphincteric — Ectopic ureterocele with the opening on the far end of the bladder neck.
- Sphincterostenotic — Ureterocele with a narrow opening located on the far end of the bladder neck.
- Cecoureterocele — Ectopic ureterocele extended into the urethra. The opening is located in the bladder.
The most common symptoms of ureteroceles can include recurring urinary tract infections, ascending urinary tract infection, and retention of urine. Patients may also suffer from recurring abdominal pain and painful kidney stones due to increased collection of uric acid particles.
Causes of ureteroceles have not been determined. The condition typically occurs in the womb during abdominal and bladder development. Researchers have not linked it to genetics, but there have been cases reported where siblings have been born with ureteroceles. The Caucasian population is more likely to suffer from ureteroceles than other groups of people.
Treatment of ureteroceles may include surgery. If a single ureter is causing symptoms, endoscopic surgery may be used to properly connect the kidney to the bladder. In the more common cases that feature two ureters being present, endoscopic surgery may also be indicated. Other medical treatments can include upper pole nephrectomy or ureteropyelostomy.
