Several classification schemes exist; most commonly used [introduced by American Academy of Pediatrics (AAP)] divides ureteroceles into intravesical and ectopic
Intravesical: Ureterocele is entirely in bladder
Ectopic: Insertion other than orthotopic position
Typically in bladder neck or urethra
More common with duplicated systems
Older classification (introduced in 1954) divided ureteroceles into simple (orthotopic) and ectopic; however, this classification has been largely abandoned due to confusion with word "simple"
"Simple" ureterocele can be seen with both simple and duplex collecting systems
~ 80% of ureteroceles (in pediatric population) are seen in association with duplicated collecting system
~ 60% of these have ectopic insertion
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Ultrasonographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Selected References
Srisajjakul S et al: Diagnostic clues, pitfalls, and imaging characteristics of '-celes' that arise in abdominal and pelvic structures. Abdom Radiol (NY). 45(11):3638-52, 2020
Hirshberg B et al: MDCT imaging of acute bladder pathology. Curr Probl Diagn Radiol. 49(6):422-30, 2020
Czarniecki M et al: Case 267: cecureterocoele manifesting in a man with infertility. Radiology. 292(1):263-6, 2019
Atta ON et al: An adult ureterocele complicated by a large stone: a case report. Int J Surg Case Rep. 44:166-71, 2018
Xiang H et al: Cobra head sign: ureterocele. J Med Imaging Radiat Oncol. 62 Suppl 1:67, 2018
Didier RA et al: The duplicated collecting system of the urinary tract: embryology, imaging appearances and clinical considerations. Pediatr Radiol. 47(11):1526-38, 2017
Cohen SA et al: Examining trends in the treatment of ureterocele yields no definitive solution. J Pediatr Urol. 11(1):29.e1-6, 2015
Adeb M et al: Magnetic resonance urography in evaluation of duplicated renal collecting systems. Magn Reson Imaging Clin N Am. 21(4):717-30, 2013
Debenedectis CM et al: Incidental genitourinary findings on obstetrics/gynecology ultrasound. Ultrasound Q. 28(4):293-8, 2012
Jesus LE et al: Clinical evolution of vesicoureteral reflux following endoscopic puncture in children with duplex system ureteroceles. J Urol. 186(4):1455-8, 2011
Pohl HG: Recent advances in the management of ureteroceles in infants and children: why less may be more. Curr Opin Urol. 21(4):322-7, 2011
Lewis JM et al: Complete excision or marsupialization of ureteroceles: does choice of surgical approach affect outcome?. J Urol. 180(4 Suppl):1819-22; discussion 1822-3, 2008
Singh I: Adult bilateral non-obstructing orthotopic ureteroceles with multiple calculi: endoscopic management with review of literature. Int Urol Nephrol. 39(1):71-4, 2007
Byun E et al: A meta-analysis of surgical practice patterns in the endoscopic management of ureteroceles. J Urol. 176(4 Pt 2):1871-7; discussion 1877, 2006
Merlini E et al: Obstructive ureterocele-an ongoing challenge. World J Urol. 22(2):107-14, 2004
Berrocal T et al: Anomalies of the distal ureter, bladder, and urethra in children: Embryologic, radiologic, and pathologic features. RadioGraphics 22: 1139-1164; 2002
Shokeir AA et al: Ureterocele: an ongoing challenge in infancy and childhood. BJU Int. 90(8):777-83, 2002
Walsh PC et al: Campbell's Urology. 8th ed. Saunders. 2007-52, 2002
Chertin B et al: Endoscopic puncture of ureterocele as a minimally invasive and effective long-term procedure in children. Eur Urol. 39(3):332-6, 2001
Davidson AJ et al: Radiology of the kidney and genitourinary tract. 3rd ed. Saunders. 213-6, 1999
Bellah RD et al: Ureterocele eversion with vesicoureteral reflux in duplex kidneys: findings at voiding cystourethrography. AJR Am J Roentgenol. 165(2):409-13, 1995
Related Anatomy
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Clinical Issues
TERMINOLOGY
Definitions
Cystic dilatation of terminal ureter
Several classification schemes exist; most commonly used [introduced by American Academy of Pediatrics (AAP)] divides ureteroceles into intravesical and ectopic
Intravesical: Ureterocele is entirely in bladder
Ectopic: Insertion other than orthotopic position
Typically in bladder neck or urethra
More common with duplicated systems
Older classification (introduced in 1954) divided ureteroceles into simple (orthotopic) and ectopic; however, this classification has been largely abandoned due to confusion with word "simple"
"Simple" ureterocele can be seen with both simple and duplex collecting systems
~ 80% of ureteroceles (in pediatric population) are seen in association with duplicated collecting system
~ 60% of these have ectopic insertion
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Ultrasonographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Selected References
Srisajjakul S et al: Diagnostic clues, pitfalls, and imaging characteristics of '-celes' that arise in abdominal and pelvic structures. Abdom Radiol (NY). 45(11):3638-52, 2020
Hirshberg B et al: MDCT imaging of acute bladder pathology. Curr Probl Diagn Radiol. 49(6):422-30, 2020
Czarniecki M et al: Case 267: cecureterocoele manifesting in a man with infertility. Radiology. 292(1):263-6, 2019
Atta ON et al: An adult ureterocele complicated by a large stone: a case report. Int J Surg Case Rep. 44:166-71, 2018
Xiang H et al: Cobra head sign: ureterocele. J Med Imaging Radiat Oncol. 62 Suppl 1:67, 2018
Didier RA et al: The duplicated collecting system of the urinary tract: embryology, imaging appearances and clinical considerations. Pediatr Radiol. 47(11):1526-38, 2017
Cohen SA et al: Examining trends in the treatment of ureterocele yields no definitive solution. J Pediatr Urol. 11(1):29.e1-6, 2015
Adeb M et al: Magnetic resonance urography in evaluation of duplicated renal collecting systems. Magn Reson Imaging Clin N Am. 21(4):717-30, 2013
Debenedectis CM et al: Incidental genitourinary findings on obstetrics/gynecology ultrasound. Ultrasound Q. 28(4):293-8, 2012
Jesus LE et al: Clinical evolution of vesicoureteral reflux following endoscopic puncture in children with duplex system ureteroceles. J Urol. 186(4):1455-8, 2011
Pohl HG: Recent advances in the management of ureteroceles in infants and children: why less may be more. Curr Opin Urol. 21(4):322-7, 2011
Lewis JM et al: Complete excision or marsupialization of ureteroceles: does choice of surgical approach affect outcome?. J Urol. 180(4 Suppl):1819-22; discussion 1822-3, 2008
Singh I: Adult bilateral non-obstructing orthotopic ureteroceles with multiple calculi: endoscopic management with review of literature. Int Urol Nephrol. 39(1):71-4, 2007
Byun E et al: A meta-analysis of surgical practice patterns in the endoscopic management of ureteroceles. J Urol. 176(4 Pt 2):1871-7; discussion 1877, 2006
Merlini E et al: Obstructive ureterocele-an ongoing challenge. World J Urol. 22(2):107-14, 2004
Berrocal T et al: Anomalies of the distal ureter, bladder, and urethra in children: Embryologic, radiologic, and pathologic features. RadioGraphics 22: 1139-1164; 2002
Shokeir AA et al: Ureterocele: an ongoing challenge in infancy and childhood. BJU Int. 90(8):777-83, 2002
Walsh PC et al: Campbell's Urology. 8th ed. Saunders. 2007-52, 2002
Chertin B et al: Endoscopic puncture of ureterocele as a minimally invasive and effective long-term procedure in children. Eur Urol. 39(3):332-6, 2001
Davidson AJ et al: Radiology of the kidney and genitourinary tract. 3rd ed. Saunders. 213-6, 1999
Bellah RD et al: Ureterocele eversion with vesicoureteral reflux in duplex kidneys: findings at voiding cystourethrography. AJR Am J Roentgenol. 165(2):409-13, 1995
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