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Ureterocele

What Is a Ureterocele?

A ureterocele is a bulge or pouch that develops at the end of the ureter, inside the bladder. It can cause a blockage and may decrease the flow of urine. This is a congenital (present at birth) condition that occurs more often in girls.

In normal anatomy, there is a single ureter (tube) connecting the kidney to the bladder. However, 90 percent of girls with an ureterocele have two ureters (duplex collecting system). It is most commonly diagnosed in children less than 2 years of age.

What Are the Symptoms of a Ureterocele?

Usually, there are no symptoms. Sometimes you may notice your child experiencing:

  • Side, back or abdominal pain
  • Urinary tract infections
  • Fever
  • Painful urination
  • Foul-smelling urine
  • Blood in the urine
  • Excessive urination

How is a Ureterocele Diagnosed?

Often, ureteroceles can be seen during prenatal ultrasounds, before the baby is born. However, some ureteroceles may not be discovered until a child is visits a healthcare provider for another problem, like a urinary tract infection.

Ultrasound

This is the first imaging test that can be used to identify a ureterocele. With a prenatal ultrasound, the condition may be discovered before the baby is born.

Voiding Cystourethrogram (VCUG)

This test is done with a series of X-rays of the bladder and lower urinary tract, using a special dye. First, a catheter is inserted into the urethra to fill the bladder with a water-based dye. Then, several X-rays are taken as the patient empties their bladder. These images allow radiologists to find problems in the anatomy and in the flow of urine.

MAG 3 Lasix Scan

This test can determine the function of each kidney, evaluate the kidneys for damage, and look for evidence of blocked urine flow across a ureterocele.

How Is a Ureterocele Treated?

Treatment for a ureterocele depends on when it is identified, its size, the degree of obstruction/reflux, and the level of kidney function. If a ureterocele is identified in the prenatal period, treatment may include antibiotics.

After the baby is born, a minor procedure called “ureterocele incision” may be performed to correct the condition. This is done soon after birth, or while the child is still an infant, and uses a small camera to navigate through the bladder and urethra to reach and puncture the ureterocele. The incision will open the blockage, and urine will be able to flow more easily.

In older children with a ureterocele, the urologist will consider a range of treatment options and may only recommend observation. In more severe cases, reconstructive urinary tract surgery will be appropriate. Your child’s urologist will discuss the options with you and recommend the best course of treatment.