Ureterocele
A ureterocele is a congenital birth defect that causes swelling in the lower part of the ureter, the narrow tubes that carry urine to the bladder. If the swelling becomes severe and grows large enough, a ureterocele may cause an obstruction in the urethra, preventing urine from leaving the body. A ureterocele may also cause damage to the kidneys, bladder and urinary tract.
Causes of a Ureterocele
While a ureterocele is considered a birth defect, the cause is mostly unknown, although they tend to run in families. A ureterocele is more common in females and may occur on one or both ureters.
Symptoms of a Ureterocele
Most cases of ureterocele do not cause any symptoms, although some patients may experience the following:
- Back pain
- Urinary tract infections
- Fever
- Painful urination
- Foul smelling urine
- Blood in the urine
A ureterocele may also put patients at a higher risk for kidney infections.
Diagnosis of a Ureterocele
A ureterocele may be diagnosed before birth during an obstetric ultrasound. While a ureterocele may be present at birth, it is often not detected until later on in life, commonly when patients are being treated for a urinary tract or kidney infection. If detected, additional testing is often performed and may include:
- Ultrasonogram
- Renal scan of the kidneys
- Voiding cystourethrogram
MRI and CT scans of the abdomen may also be performed to confirm a diagnosis of a ureterocele
Treatment of a Ureterocele
Treatment for a ureterocele will depend on the age of the patient and the severity of the condition. Antibiotics are usually prescribed to treat any infection caused by the ureterocele. Very mild cases may not require any treatment and may only need to be observed regularly. However, in most cases, a ureterocele will often require a surgical procedure to fully treat the condition.
Several procedures are commonly performed to treat a ureterocele.
Transurethral Puncture
A transurethral puncture procedure drains and decompresses the ureterocele. A cystoscope is inserted through the urethra and it is used to puncture the ureterocele, which then drains. This procedure works best when the ureterocele is only inside the bladder.
Removal of Ureterocele
In some cases, the ureterocele may need to be removed. The ureterocele is removed through the bladder, which is then reconstructed and the ureters re-implanted.
Upper Pole Nephrectomy
An upper pole nephrectomy involves the removal of the affected portion of the kidney. It is often performed laparoscopically through a small incision under the rib cage.
Nephrectomy
A nephrectomy is the removal of the entire kidney. If the ureterocele affects the function of the entire kidney, removal of the kidney may be recommended.
Patients may require more than one procedure in order to successfully treat a ureterocele. A doctor will determine a treatment plan that is best for the patient's individual condition.