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.
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
- Frequent urination
- Painful urination
- Burning sensation during urination
- 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:
- 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.
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.
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.