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Ureterocele
Karen Y. Oh, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Definitions

                • Congenital dilatation of intramucosal segment of ureter
                  • Dilated segment prolapses into bladder lumen
                • Variable types
                  • Simple
                    • Occurs at normal ureterovesical junction
                    • Located at trigone of bladder
                    • Not usually seen in utero
                  • Ectopic
                    • Almost always associated with renal duplication
                    • Located medially and inferiorly to trigone, near bladder base
                    • Ectopic ureter is usually stenotic at bladder
                    • Ectopic ureter may insert outside of bladder
                      • Directly onto perineum
                      • Urethra
                      • Females: Vagina, uterus
                      • Males: Epididymis, seminal vesicles, ejaculatory ducts, vas deferens
                  • Cecoureterocele
                    • Uncommon type of ectopic ureterocele
                    • Dissects submucosally into urethra
                    • Can cause intermittent bladder outlet obstruction

              IMAGING

              • General Features

                • Ultrasonographic Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        CLINICAL ISSUES

                        • Presentation

                          • Demographics

                            • Natural History & Prognosis

                              • Treatment

                                DIAGNOSTIC CHECKLIST

                                • Consider

                                  • Image Interpretation Pearls

                                    Selected References

                                    1. Timberlake MD et al: Minimally invasive techniques for management of the ureterocele and ectopic ureter: upper tract versus lower tract approach. Urol Clin North Am. 42(1):61-76, 2015
                                    2. Torres Montebruno X et al: Fetoscopic laser surgery to deobstruct a prolapsed Ureterocele. Ultrasound Obstet Gynecol. 46(5): 623-6, 2015
                                    3. Queiroga EE Jr et al: Antenatal diagnosis of renal duplication by ultrasonography: report on four cases at a referral center. Urol J. 10(4):1142-6, 2014
                                    4. Godinho AB et al: Ureterocele: antenatal diagnosis and management. Fetal Diagn Ther. 34(3):188-91, 2013
                                    5. Castagnetti M et al: Management of duplex system ureteroceles in neonates and infants. Nat Rev Urol. 6(6):307-15, 2009
                                    6. Kitchens DM et al: Antenatal hydronephrosis. Curr Urol Rep. 10(2):126-33, 2009
                                    7. Morris RK et al: Antenatal ultrasound to predict postnatal renal function in congenital lower urinary tract obstruction: systematic review of test accuracy. BJOG. 116(10):1290-9, 2009
                                    8. Kajbafzadeh AM et al: Comparison of magnetic resonance urography with ultrasound studies in detection of fetal urogenital anomalies. J Pediatr Urol. 4(1):32-9, 2008
                                    9. Kiddoo DA et al: Cross-fused ectopic multicystic dysplastic kidney with associated ureterocele. Urology. 66(2):432, 2005
                                    10. Ashmead GG et al: Fetal bladder outlet obstruction due to ureterocele: in utero "colander" therapy. J Ultrasound Med. 23(4):565-8, 2004
                                    11. Clark TJ et al: Prenatal bladder drainage in the management of fetal lower urinary tract obstruction: a systematic review and meta-analysis. Obstet Gynecol. 102(2):367-82, 2003
                                    12. Sepulveda W et al: Prenatal sonographic diagnosis of bilateral ureteroceles: the pseudoseptated fetal bladder. J Ultrasound Med. 22(8):841-4; quiz 845-6, 2003
                                    13. Soothill PW et al: Ultrasound-guided laser treatment for fetal bladder outlet obstruction resulting from ureterocele. Am J Obstet Gynecol. 188(4):1107-8, 2003
                                    14. Sozubir S et al: Prenatal diagnosis of a prolapsed ureterocele with magnetic resonance imaging. Urology. 62(1):144, 2003
                                    15. Whitten SM et al: Accuracy of antenatal fetal ultrasound in the diagnosis of duplex kidneys. Ultrasound Obstet Gynecol. 21(4):342-6, 2003
                                    16. Kraus SJ: Genitourinary imaging in children. Pediatr Clin North Am. 48(6):1381-424, 2001
                                    17. Quintero RA et al: In-utero treatment of fetal bladder-outlet obstruction by a ureterocele. Lancet. 357(9272):1947-8, 2001
                                    18. Staatz G et al: Magnetic resonance urography in children: evaluation of suspected ureteral ectopia in duplex systems. J Urol. 166(6):2346-50, 2001
                                    19. Kang AH et al: Antenatal ultrasonographic development of ureteroceles. Implications for management. Fetal Diagn Ther. 13(3):157-61, 1998
                                    Related Anatomy
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                                    Related Differential Diagnoses
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                                    References
                                    Tables

                                    Tables

                                    KEY FACTS

                                    • Terminology

                                      • Imaging

                                        • Top Differential Diagnoses

                                          • Pathology

                                            • Clinical Issues

                                              • Diagnostic Checklist

                                                TERMINOLOGY

                                                • Definitions

                                                  • Congenital dilatation of intramucosal segment of ureter
                                                    • Dilated segment prolapses into bladder lumen
                                                  • Variable types
                                                    • Simple
                                                      • Occurs at normal ureterovesical junction
                                                      • Located at trigone of bladder
                                                      • Not usually seen in utero
                                                    • Ectopic
                                                      • Almost always associated with renal duplication
                                                      • Located medially and inferiorly to trigone, near bladder base
                                                      • Ectopic ureter is usually stenotic at bladder
                                                      • Ectopic ureter may insert outside of bladder
                                                        • Directly onto perineum
                                                        • Urethra
                                                        • Females: Vagina, uterus
                                                        • Males: Epididymis, seminal vesicles, ejaculatory ducts, vas deferens
                                                    • Cecoureterocele
                                                      • Uncommon type of ectopic ureterocele
                                                      • Dissects submucosally into urethra
                                                      • Can cause intermittent bladder outlet obstruction

                                                IMAGING

                                                • General Features

                                                  • Ultrasonographic Findings

                                                    • Imaging Recommendations

                                                      DIFFERENTIAL DIAGNOSIS

                                                        PATHOLOGY

                                                        • General Features

                                                          CLINICAL ISSUES

                                                          • Presentation

                                                            • Demographics

                                                              • Natural History & Prognosis

                                                                • Treatment

                                                                  DIAGNOSTIC CHECKLIST

                                                                  • Consider

                                                                    • Image Interpretation Pearls

                                                                      Selected References

                                                                      1. Timberlake MD et al: Minimally invasive techniques for management of the ureterocele and ectopic ureter: upper tract versus lower tract approach. Urol Clin North Am. 42(1):61-76, 2015
                                                                      2. Torres Montebruno X et al: Fetoscopic laser surgery to deobstruct a prolapsed Ureterocele. Ultrasound Obstet Gynecol. 46(5): 623-6, 2015
                                                                      3. Queiroga EE Jr et al: Antenatal diagnosis of renal duplication by ultrasonography: report on four cases at a referral center. Urol J. 10(4):1142-6, 2014
                                                                      4. Godinho AB et al: Ureterocele: antenatal diagnosis and management. Fetal Diagn Ther. 34(3):188-91, 2013
                                                                      5. Castagnetti M et al: Management of duplex system ureteroceles in neonates and infants. Nat Rev Urol. 6(6):307-15, 2009
                                                                      6. Kitchens DM et al: Antenatal hydronephrosis. Curr Urol Rep. 10(2):126-33, 2009
                                                                      7. Morris RK et al: Antenatal ultrasound to predict postnatal renal function in congenital lower urinary tract obstruction: systematic review of test accuracy. BJOG. 116(10):1290-9, 2009
                                                                      8. Kajbafzadeh AM et al: Comparison of magnetic resonance urography with ultrasound studies in detection of fetal urogenital anomalies. J Pediatr Urol. 4(1):32-9, 2008
                                                                      9. Kiddoo DA et al: Cross-fused ectopic multicystic dysplastic kidney with associated ureterocele. Urology. 66(2):432, 2005
                                                                      10. Ashmead GG et al: Fetal bladder outlet obstruction due to ureterocele: in utero "colander" therapy. J Ultrasound Med. 23(4):565-8, 2004
                                                                      11. Clark TJ et al: Prenatal bladder drainage in the management of fetal lower urinary tract obstruction: a systematic review and meta-analysis. Obstet Gynecol. 102(2):367-82, 2003
                                                                      12. Sepulveda W et al: Prenatal sonographic diagnosis of bilateral ureteroceles: the pseudoseptated fetal bladder. J Ultrasound Med. 22(8):841-4; quiz 845-6, 2003
                                                                      13. Soothill PW et al: Ultrasound-guided laser treatment for fetal bladder outlet obstruction resulting from ureterocele. Am J Obstet Gynecol. 188(4):1107-8, 2003
                                                                      14. Sozubir S et al: Prenatal diagnosis of a prolapsed ureterocele with magnetic resonance imaging. Urology. 62(1):144, 2003
                                                                      15. Whitten SM et al: Accuracy of antenatal fetal ultrasound in the diagnosis of duplex kidneys. Ultrasound Obstet Gynecol. 21(4):342-6, 2003
                                                                      16. Kraus SJ: Genitourinary imaging in children. Pediatr Clin North Am. 48(6):1381-424, 2001
                                                                      17. Quintero RA et al: In-utero treatment of fetal bladder-outlet obstruction by a ureterocele. Lancet. 357(9272):1947-8, 2001
                                                                      18. Staatz G et al: Magnetic resonance urography in children: evaluation of suspected ureteral ectopia in duplex systems. J Urol. 166(6):2346-50, 2001
                                                                      19. Kang AH et al: Antenatal ultrasonographic development of ureteroceles. Implications for management. Fetal Diagn Ther. 13(3):157-61, 1998