- Laurence S Baskin, MD, FAAP
Laurence S Baskin, MD, FAAP
- Section Editor — Pediatric Urology
- Frank Hinman, Jr, MD, Distinguished Professorship in Pediatric Urology
- Chief Pediatric Urology
- Professor of Urology and Pediatrics
- UCSF Benioff Children's Hospital
A ureterocele is a cystic dilatation of the terminal ureter within the bladder and/or the urethra (figure 1). It may present as an incidental finding on antenatal ultrasonography, or postnatally because of symptoms due to urinary tract infection (UTI) or obstruction.
Ureterocele, including its pathophysiology, clinical presentation, diagnosis, evaluation, and management will be reviewed here.
At autopsy, the incidence of ureteroceles has been reported as 1 in 500 cases . Ureteroceles occur four to six times more frequently in females than in males, and more commonly in Caucasians than in other races . Unilateral ureteroceles occur with similar frequency on the right and left, and in 10 percent of cases there is bilateral involvement.
The classification system adopted by the Section on Urology of the American Academy of Pediatrics divides ureteroceles based on their location . According to this system, ureteroceles are classified as intravesical (ie, entirely within the bladder) or ectopic (ie, a portion extends beyond the bladder neck into the urethra) (figure 1). At times, differentiating between intravesical and ectopic ureteroceles may be difficult. Historically, ectopic ureteroceles that inserted beyond the bladder neck into the urethra were called cecoureteroceles.
Ureteroceles also may be classified depending upon whether they are associated with either a single collecting system (ie, single ureter and kidney) or a double collecting (duplex) system (complete ureteral duplication). Approximately 80 percent of ureteroceles are associated with the upper pole of a duplex collecting system, and 60 percent of these are ectopic , whereas intravesical ureteroceles are more common in single systems.
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- CLINICAL PRESENTATION
- DIAGNOSIS AND EVALUATION
- Voiding cystourethrogram
- - Intravesical versus ectopic
- - Duplex system
- - Single system
- - Age at presentation
- - Reflux
- Our approach
- SUMMARY AND RECOMMENDATIONS