Ureterocele

A Ureterocele, English Ureterocele is a spherical enlargement of a portion of the ureter in the urinary bladder during or after passage through the bladder wall. A distinction orthotopic ( intravesical ) and ectopic ( caudal dystopic ) ureteroceles depending on the reference to the ostium. A ureterocele is frequently associated with ureteral stenosis or a vesikorenalem reflux, but can also remain asymptomatic.

Basically, the portion of the ureter, the bladder extends in the wall concerned. Ureteroceles can be very large and fill the entire bladder may and thus may miss out on a sonographic detection. If, by such large ureteroceles for compression of the opposite ureter, it can lead to a two-sided Harnaufstau possibly with subsequent renal failure.

In most cases, a ureterocele there is a double unit kidney, where the outflow from the upper ( cranial ) cavity system caudal dystopic and from the lower ( caudal ) System orthotopic flows ( Weigert -Meyer rule). Approximately 10 % is in orthotopic ureterocele a normal installation of the ring system, also due to regularly occurring symptoms appear or are late adult ureterocele called.

The ureterocele often has only a very small opening into the bladder and bulges depending on the filling state in the bladder before. This stenosis causes a Harnabflusstörung in the corresponding hollow system, the ureter can be run geschlänget in its whole course to the kidney and extended saccular. Increases in pressure in the renal collecting system affecting the renal system, drainage disorders of the urinary organs are often a cause of secondary or chronic infection.

Diagnosis

Possibly. can be found in Harnbefund signs of chronic infection, however, is nonspecific. Urography detected by the detection of a characteristic notch in the bubble shadows and an extension of the corresponding hollow system, " snake head sign," the diagnosis when Miktionscystoureterogramm: Earlier it was in the X-ray. Today, the diagnosis on sonography of the urinary tract with the guiding criteria based

• Marginal cyst on Blasenbloden
• Enhanced afferent ureter
• Double conditioning of the hollow system of a kidney

Therapy

For treatment, various methods are available:

• Endoscopic slitting of the ureterocele, method of first choice.
• Neueinpflanzung of the ureter with antireflux plastic into the bladder wall.
• Making a connection between two units of the duplicated renal pelvis with partial removal of the then non-functioning second ureter.
• With the substantial loss of function of the associated kidney proportion of these can be removed with Teilentferung of the corresponding ureter.