Ureterocele

Ureterocele is cystic dilatation of the

intravesical segment of the distal ureter

Occurs in 1 per 4000 population and often

occurs in women (4-7 times compared to
men)
 Etiology
• It is non inherited or genetic disorder
• Delayed canalization of Chwalla membrane
(membrane that separate the ureteric bud
from the urogenital sinus) during
embryogenesis which causes obstruction of
the ureteric orifice
 Classifications
a. According to position
Intravesical ureterocel and Prolapsing

b. According to the location of ureteric orifice

Orthotopic (25%) and Ectopic (75%)

c. According to renal collecting system

Single system and duplex system
 Clinical Sign
• Urinary retention
• Hematuria
• Abdominal distention
• Abdominal or colic pain
• Urinary tract infection
Ureteral Duplication
• Most common congenital renal abnormality,
1 : 125 of birth
• Incomplete ureteral duplication, in which one
common ureter enters the bladder
• Complete ureteral duplication, in which two
ureters ipsilaterally enter the bladder
 In cases of ureteral duplication where the
ureteral bud arises twice, the lower-pole
ureter integrates with the bladder earlier than
expected and, as a result, is carried into a
more superolateral position. Thus, the distal
ureter is poorly supported by the trigone and
has a shorter intramural tunnel, both of which
situations increase the likelihood of VUR.
 Clinical sign
Commonly asymptomatic, but the
symptoms occur when something happen like
obstruction, reflux, infection, etc
• Hydronephrosis
• Urinary tract infection
• Vesicoureteral reflux
Ureter Ectopic
Ureteral ectopia is defined as a ureter that
terminates into an abnormal location.
Instead of draining into the bladder, the
ureteral orifice is located in the urethra,
vagina, uterus (in woman) or ductus deferens,
seminal vesicles, urethra (in man)
In ureteral duplication, two ipsilateral ureteral buds
migrate separately and simultaneously toward the
urogenital sinus.
Ectopia of one or both ureters may occur; however,
ectopia of only the upper pole ureter is usually
present, because it is the second ureter to be
incorporated onto the trigone. Its late arrival to the
urogenital sinus causes the migrating mesonephric
duct to carry the ureter to an abnormal location
outside the bladder
• Urinary track infection
• Incontinence
• Vesicoureteral reflux
• Abdominal pain and swelling