Understanding ureteroceles

Definition

Cystic dilatation of the terminal ureter within the bladder, urethra, or both.

Types

Categorized according to ureterocele insertion/based on location:

Orthotopic (intravesical) ureterocele is a term used for a ureterocele contained within the bladder.

Voiding cystourethrogram – left ureterocele

Ectopic (extravesical) ureterocele refers to ureteroceles with tissue that originates at the bladder neck or beyond, into the urethra.

Categorized according to ureterocele insertion/based on location:

Seen in 20% of cases.

Single-system ureteroceles usually are associated with better function and less hydronephrosis than duplex renal units and their more frequently associated ectopic ureteroceles.

Seen in 80% of cases.

Use the Weigert-Meyer Rule.
In complete ureter duplication: The upper renal and lower renal moieties are drained by separate ureters, each having its own ureteral orifice in the bladder.

  • The upper moiety ureter presents an ectopic insertion (inferomedially) being prone to obstruction, often due to an ureterocele.
  • The lower moiety ureter presents an orthotopic insertion and vesicoureteral reflux can occur.

Facts & Figures

1/5000

incidence in live births.

10%

of bilateral involvement in cases.

  • Much more common in females than in males.
  • Similar frequency of unilateral ureterocele on the right and left
  • Frequently associated with:
    - variable degree of bladder muscle deficiency
    - upper pole of duplex kidney with variable function
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