Ectopic ureterocele

An ectopic ureterocele is commonly associated with the ectopically inserted ureter of a duplicated collecting system and more common in female fetuses.1Kang A.H. Bruner J.P. Antenatal ultrasonographic development ureteroceles. Implications for management.Fetal Diagn Ther. 1998; 13: 157-161Crossref PubMed Scopus (7) Google Scholar,2Shokeir A.A. Nijman R.J. Ureterocele: an ongoing challenge infancy childhood.BJU Int. 2002; 90: 777-783Crossref (50) Scholar It can be detected on prenatal imaging as incidental finding or during evaluation hydronephrosis. A cystic dilation terminal ureter. The American Academy Pediatrics classifies ureteroceles based their location. Intravesical are located entirely bladder adults than fetuses children.3Coplen D.E. Duckett J.W. modern approach to ureteroceles.J Urol. 1995; 153: 166-171Crossref (130) Ectopic distal trigone, inserting into neck, urethra (cecoureterocele), elsewhere pelvis, likely pediatric imaging.4Glassberg K.I. Braren V. et al.Suggested terminology duplex systems, ureters 1984; 132: 1153-1154Crossref (151) Approximately 80% upper pole system; moreover, 60% these ectopic.3Coplen Scholar,5Athey P.A. Carpenter Hadlock F.P. Hedrick T.D. Ultrasonic demonstration ureterocele.Pediatrics. 1983; 71: 568-571PubMed On ultrasound, appears thin-walled mass seen fetal bladder. best visualized when partially filled. confused completely empty. Conversely, become compressed prolapse if full.6Garmel S.H. Crombleholme T.M. Cendron M. Klauber G. D’Alton M.E. vanishing ureterocele: cause concern?.Prenat Diagn. 1996; 16: 354-356Crossref (4) Therefore, should once throughout ultrasound examination. When suspected, bladder, bilateral kidneys, ureters, amniotic fluid carefully evaluated. kidneys both axially longitudinally. Obstruction by at ureterovesical junction lead dilated Renal duplication often visualization two separate renal poles, most draining moiety.7Queiroga Jr., E.E. Martins M.G. Rios L.T. al.Antenatal diagnosis ultrasonography: report four cases referral center.Urol J. 2014; 10: 1142-1146PubMed from moiety. In addition, lower moiety dilated, generally reflux. kidney may larger contralateral kidney. also displaced inferiorly because effect. If sufficiently large, it obstruction outlet obstruction, resulting oligohydramnios. Ureteroceles isolated anomalies not outside urologic system. assess duplication. represents ureterocele. examined look differential diagnoses include hydronephrosis, such posterior urethral valves, ureteropelvic vesicoureteral reflux, congenital megaureter. However, conditions, normal. “hutch” diverticulum, periureteral have similar appearance that ureterocele, but extrinsic does lumen. crescentic membrane considered pathognomonic (Figure). sporadic finding. absence other concerning family history, genetic beyond routine aneuploidy screening recommended. Follow-up examination recommended follow growth, measure volume, obstruction. utero decompression laser incision needle puncture has been described oligohydramnios8Chalouhi G.E. Morency A.M. De Vlieger R. al.Prenatal causing obstruction: multicenter case series.Prenat 2017; 37: 968-974Crossref (9) specialty centers under research protocol. Prenatal urology neonatology consultations provide counseling about prognosis postnatal management. Obstetrical management, delivery timing, mode obstetrical indications. largely dependent degree excellent reflux.9Shankar K.R. Vishwanath N. Rickwood Outcome patients prenatally ureterocele; natural history those managed expectantly.J 2001; 165: 1226-1228Crossref (52) Scholar,10Rickwood Reiner I. Jones Pournaras C. Current management duplex-system ureteroceles: experience 41 patients.Br J 1992; 70: 196-200Crossref (56) antenatally, present urinary tract infection first months infancy3Coplen urosepsis. improved earlier initial intervention indicated. one retrospective study 95 diagnosis, incidence was decreased need secondary procedures (20% vs 46%).11Upadhyay Bolduc S. Braga L. al.Impact morbidity management.J 167: 2560-2565Crossref workup includes voiding cystourethrogram. radionucleotide scan help function. Pediatric consultation Surgery considered, especially Surgical options endoscopic decompression, heminephrectomy, reconstruction, ureteral reimplantation. ultrasonographically varying degrees Serial follow-up examinations progression Postnatal surgery necessary, severe