A ureterocele is an anatomical abnormality that results in a small swelling at the end of one of the ureters, the tubes that carry urine from the kidney to the bladder. This swelling can block urine from being moved out of the urinary system.
What causes ureteroceles?
The lower ureters where the tube connects to the bladder is swollen, and urine can’t flow freely into the bladder, so the urine collects in the ureters and stretches it, expanding it in the same way a water balloon might. Urine can also flow back into the kidney (reflux). It is believed that up to one in every 4,000 people have a ureteroceles. Both ureters are susceptible.
The main symptoms of ureteroceles include:
- Abdominal pain
- Back pain, but often only on one side
- Side (flank) pain that can be severe, and go down into the groin, genitals and thigh
- Bloody urine
- Burning on urination (dysuria)
- Malodorous urine (smells bad)
- Frequent/urgent urination
- A lump felt in the abdomen
- Ureterocele tissue falls through the urethra into the vulva (urethral prolapse)
- Unable to hold urine (incontinence)
- Urinary tract infections
Diagnosis of ureteroceles
It is easier to spot a large ureteroceles than a smaller one, and many can be spotted during ultrasounds in pregnancy. Other times, a person may remain asymptomatic for many years, or the problem is found later with kidney stones or another type of infection. Urinalysis may be done to discover if there is blood in the urine, or any signs of a urinary tract infection.
Tests done to detect ureteroceles
- Abdominal ultrasound
- CT scan (abdomen)
- Cystoscopy (looking inside the bladder)
- Radionuclide renal (kidney) scan
- Voiding cystourethrogram
- Blood pressure (high blood pressure can result from kidney damage from reflux)
Antibiotics may be the first port of call to clear up any infections, after which surgery is likely to be recommended. The point of the surgery is to remove the blockage (the small swelling), and is performed by making a cut into the ureterocele itself, or in fact by removing the ureterocele and reattaching the ureters to the bladder.
Surgery solves the problem the majority of the time. Outcomes, however, vary since damage is very unique to each individual. Permanent kidney damage can be the end result for some people, but kidney failure is actually uncommon. The other kidney usually works just fine. Problems that can arise are long-term damage to the kidneys, bladder and constant or recurring urinary tract infections. Ureteroceles cannot be treated at home, and require medical attention.