Ureterocele: Symptoms, Causes, Diagnosis and Treatment | Dr. Prashant Jain

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Ureterocele Symptoms, Causes, Diagnosis and
Treatment Dr. Prashant Jain Ureterocele Introd
uction
A ureterocele is a condition that involves
swelling of the terminal end of ureter. Ureter
joins the kidney with the bladder. It is formed
as aresult of obstruction at the junction of
ureter and bladder. The condition can be
detected during pregnanacy on antenatal scan.
Also it can present with symptoms of urinary
tract infection and urinary incontinence.
Ureterocele
The condition can be unilateral or bilateral and
sometimes may be associated with duplex system
i.e. one kidney is supplied with two ureters. The
condion as a result of obstruction can cause
hydronephrosis with back pressure changes in
kidney.Sometimes it can associated with
vesicoureteric reflux.
Symptoms Of Ureterocele
Your child may experience the following symptoms
due to ureterocele

• Abdominal pain
• Urinary tract infection

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• Frequent urination
• Painful urination
• Burning sensation during urination
• Fever
• Urinary Incontinenece
• Causes Of Ureterocele

The exact reason for this condition is not known.
The condition may be due to a problem in the
development of the urinary system during fetal
development.
Risk Factors For Ureterocele
The exact cause of Ureterocele remains unknown.
However, certain factors increase the risk of
developing this condition. These factors include

• Gender Girls are at more risk as compared to
  boys.
• Race This condition is more common in whites as
  compared to others
• Diagnosis Of Ureterocele

Your doctor may diagnose ureterocele through the
following methods
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• Prenatal scan The doctor may diagnose this
  condition before the birth of the child. During
  the evaluation for the presence of
  hydronephrosis, the doctor may diagnose
  ureterocele through prenatal ultrasound.
• Renal bladder ultrasound Ureterocele normally
  causes urinary tract infection. Once the doctor
  diagnoses urinary tract infection in your child,
  he may advise you for various imaging tests.
  Renal bladder ultrasound may help in diagnosing
  ureterocele.
• MRI MRI helps in performing the comprehensive
  evaluation of the complete urinary system,
  including the kidneys, ureter, and bladder. The
  high-quality, detailed images through MRI helps
  in diagnosing ureterocele.
• MAG III Renal scan The doctor performs this
  test to determine the functional status of the
  kidney and to know the obstructive drainage.
• Voiding cystourethrogram During this procedure,
  the doctor fills the bladder with a solution
  with the help of a urethral catheter. The doctor
  takes the images of the bladder with the help of
  an instrument to determine the presence of
  ureterocele. The doctor also analyses if the
  solution is going back to the kidney
  (vesicoureteric reflux).
• Treatment For Ureterocele

The doctor customizes the treatment for
ureterocele depending upon various factors.
These factors include the severity of the
condition, presence of vesicoureteral reflux,
size of ureterocele, effect on kidney function,
and if the ureterocele extends into the bladder.
Following are some of the options for treating
ureterocele
Conservative Management This is adviced in cases
who are aymptomatic without any back pressure
changes in kidney.Rest of the cases might require
some form of intervention.
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Endoscopic ureterocele puncture Your doctor may
perform this procedure soon after birth or when
your child is in the infancy stage. The doctor
performs this procedure under general anesthesia
with the help of a cystoscope. The doctor
punctures the ureterocele to ensure the urinary
drainage.
Upper pole nephrectomy If your doctor diagnoses
duplex kidney and the upper pole is not
performing any function, he may advise you to
undergo upper pole nephrectomy. The doctor
removes the upper pole of the kidney through
minimally invasive surgery.
Ureteral reimplantation The doctor performs
ureteral reimplantation through minimally
invasive surgery. The doctor removes the
ureterocele and reimplants the ureter to join it
with the bladder.
Prognosis Of ureterocele
Ureterocele has an excellent prognosis. The
doctor should diagnose the condition at an early
stage to prevent any permanent damage to the
kidneys. If the doctor diagnoses the condition
at an early stage, even the ureterocele of high
severity may be effectively managed. Most
children achieve normal urinary function after
ureterocele treatment.
Complications Of Ureterocele
Following are some of the complications of
ureterocele
Hydronephrosis The urine flows back, resulting
in swelling of kidneys due to ureterocele.
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Vesicoureteral reflux The urine flows back into
the kidneys, thereby increasing the risk of
kidney infection and kidney damage.
Kidney stones Ureterocele may also increase the
risk of developing kidney stones.