Ureteroceles

Abstract

Ureteroceles are congenital cystic dilations of the distal aspect of the ureter which often lead to partial or complete obstruction of their associated renal unit with resulting hydroureteronephrosis. They are often diagnosed postnatally with imaging evaluation prompted by an abnormality detected on prenatal ultrasonography. Ureteroceles vary in size from small to very large, and also vary in location from intravesical to ectopic. Several classification systems exist which will be further discussed in this chapter. Controversy exists regarding the therapeutic approach to ureteroceles, which depends on the presence of concurrent congenital anomalies like ureteral duplication and/or the presence of vesicoureteral reflux. This chapter will discuss management options for ureterocele including observation, endoscopic puncture, excision, or marsupialization with ureteral reimplantation, ureteroureterostomy, and total reconstruction. Although there is controversy over the best treatment for patients with ureteroceles, the goals of treatment remain the same: preservation of renal function, elimination of obstruction and reflux, prevention of urinary infection, and maintenance of urinary continence.KeywordsPediatric urologyUreterocelesDuplicated systemHydronephrosisEctopic ureterVesicoureteral refluxUrinary obstructionUrinary tract infection