Skip to main content
SpringerLink
Log in

Ureteroceles

  • Living reference work entry
  • First Online:
Pediatric Surgery

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.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  • Barthold JS. Editorial: individualized approach to the prenatally diagnosed ureterocele. J Urol. 1998;159:1011–2.

    Article  PubMed  CAS  Google Scholar 

  • Besson R, Tran Ngoc B, Laboure S, Debeugny P. Incidence of urinary tract infection in neonates with antenatally diagnosed ureteroceles. Eur J Pediatr Surg. 2000;10:111–3.

    Article  PubMed  CAS  Google Scholar 

  • Bilgutay AN, Kirsch AJ. Robotic ureteral reconstruction in the pediatric population. Front Pediatr. 2019 Mar 22;7:85.

    Article  PubMed  PubMed Central  Google Scholar 

  • Castagnetti M, Cimador M, Sergio M, de Grazia E. Transurethral incision of duplex system ureteroceles in neonates: does it increase the need for secondary surgery in intravesical and ectopic cases? BJU Int. 2004;93(9):1313–7.

    Article  PubMed  CAS  Google Scholar 

  • Chertin B, Mohanan N, Farkas A, Puri P. Endoscopic treatment of vesicoureteral reflux associated with ureterocele. J Urol. 2007;178:1594–7.

    Article  PubMed  Google Scholar 

  • Cooper CS, Passerini-Glazel G, Hutcheson JC, Iafrate M, Camuffo C, Milani C, Snyder HM. Long-term follow-up of endoscopic incision of ureteroceles: intravesical versus extravesical. J Urol. 2000;164:1097–9.

    Article  PubMed  CAS  Google Scholar 

  • Coplen DE, Austin PF. Outcome analysis of prenatally detected ureteroceles associated with multicystic dysplasia. J Urol. 2004;172:1637–9.

    Article  PubMed  Google Scholar 

  • Coplen DE, Duckett JW. The modern approach to ureteroceles. J Urol. 1995;153:166–71.

    Article  PubMed  CAS  Google Scholar 

  • Denes F, Danilovic A, Srougi M. Outcomes of laparoscopic upper-pole nephrectomy in children with duplex systems. J Endourol. 2007;21:162–8.

    Article  PubMed  Google Scholar 

  • Di Benedetto V, Morrison-Lacombe G, Begnara MG. Transurethral puncture of ureterocele associated with single collecting system in neonates. J Pediatr Surg. 1997;32:1325–7.

    Article  PubMed  Google Scholar 

  • Direnna T, Leonard M. Watchful waiting for prenatally detected ureteroceles. J Urol. 2006;175:1493–5.

    Article  PubMed  Google Scholar 

  • Ericsson NO. Ectopic ureterocele in infants and children: a clinical study. Acta Chir Scand. 1954;197:1–93.

    CAS  Google Scholar 

  • Fuchs J, Luithle T, Warmann S, Haber P, Blumenstock G, Szavay P. Laparoscopic surgery on upper urinary tract in children younger than 1 year: technical aspects and functional outcome. J Urol. 2009;182:1561–8.

    Article  PubMed  CAS  Google Scholar 

  • Glassberg KI, Braren V, Duckett JW, Jacobs ED, King LR, Lebowitz RL, Perlmutter AD, Stephens FD. Suggested terminology for duplex systems, ectopic ureters and ureteroceles. Report of the committee on terminology, nomenclature and classification. Am Acad Pediatr J Urol. 1984;132:1153–4.

    CAS  Google Scholar 

  • Gotoh T, Koyanagi T, Matsuno T. Surgical management of ureteroceles in children: strategy based on the classification of ureteral hiatus and the eversion of ureteroceles. J Pediatr Surg. 1988;23:159–65.

    Article  PubMed  CAS  Google Scholar 

  • Gran CD, Kropp BP, Cheng EY, Kropp KA. Primary lower urinary tract reconstruction for nonfunctioning renal moieties associated with obstructing ureteroceles. J Urol. 2005;173:198–201.

    Article  PubMed  Google Scholar 

  • Grossklaus DJ, Pope JC, Adams MC, Brock JW. Is postoperative cystography necessary after ureteral reimplantation? Urology. 2001;58(6):1041–5.

    Article  PubMed  CAS  Google Scholar 

  • Han MY, Gibbins MD, Belman AB, Pohl HG, Majd M, Rushton HG. Indications for nonoperative management of ureteroceles. J Urol. 2005;174:1652–6.

    Article  PubMed  Google Scholar 

  • Heyman J, Kallet S. Transitional cell carcinoma occurring in ureterocele. Urology. 1984;24(2):175–7.

    Article  PubMed  CAS  Google Scholar 

  • Husmann DA, Ewalt DH, Glenski WJ, Bernier PA. Ureterocele associated with ureteral duplication and a nonfunctioning upper pole segment: management by partial nephroureterectomy alone. J Urol. 1995;154:723–6.

    Article  PubMed  CAS  Google Scholar 

  • Jawdat J, Rotem S, Kocherov S, Farkas A, Chertin B. Does endoscopic puncture of ureterocele provide not only an initial solution, but also a definitive treatment in all children? Over the 26 years of experience. Pediatr Surg Int. 2018 May;34(5):561–5.

    Article  PubMed  Google Scholar 

  • Kalisvaart JF, Kirsch AJ. Ureteroceles in the newborn. In: Puri P, editor. Newborn surgery. 3rd ed. Hodder Arnold; 2011.

    Google Scholar 

  • Kirsch AJ, Grattan-Smith JD. Magnetic resonance imaging of the pediatric urinary tract. In: Gearhart JP, Rink RC, PDE M, editors. Pediatric urology. 2nd ed. WB Saunders; 2010. p. 162–71.

    Chapter  Google Scholar 

  • Lee RS, Sethi AS, Passerotti CC, Retik AB, Borer JG, Nguyen HT, Peters CA. Robot assisted laparoscopic partial nephrectomy: a viable and safe option in children. J Urol. 2009;181(2):823–8.

    Article  PubMed  Google Scholar 

  • Lewis J, Cheng E, Campbell J, Kropp B, Liu D, Kropp K, Kaplan W. Complete excision or marsupialisation of ureteroceles: does choice of surgical approach affect outcome? J Urol. 2008;180:1819–23.

    Article  PubMed  Google Scholar 

  • McLeod DJ, Alpert SA, Ural Z, Jayanthi VR. Ureteroureterostomy irrespective of ureteral size or upper pole function: a single center experience. J Pediatr Urol. 2014; https://doi.org/10.1016/j.jpurol.2014.05.003.

  • Pani E, Negri E, Cini C, Landi L, Mantovani A, Bortot G, Masieri L. Endoscopic treatment of ureterocele in children: Results of a single referral tertiary center over a 10 year-period. J Pediatr Urol. 2022 Apr;18(2):182.e1–6.

    Article  Google Scholar 

  • Paquin AJ. Ureterovesical anastomosis: the description and evaluation of a technique. J Urol. 1959;82:573.

    Article  PubMed  Google Scholar 

  • Payabvash S, Kajbafzadeh AM, Saeedi P, Sadeghi Z, Elmi A, Mehdizadeh M. Application of magnetic resonance urography in diagnosis of congenital urogenital anomalies in children. Pediatr Surg Int. 2008;24:979–86.

    Article  PubMed  Google Scholar 

  • Perez-Brayfield M, Kirsch AJ, Hensle TW, Koyle MA, Furness P, Scherz HC. Endoscopic treatment with dextranomer/hyaluronic acid for complex cases of vesicoureteral reflux. J Urol. 2004;172:1614–6.

    Article  PubMed  CAS  Google Scholar 

  • Peters CA, Schlussel RN, Mendelsohn C. Ectopic ureter, ureterocele, and ureteral anomalies. In: WS MD, Wein AJ, Kavoussi LR, et al., editors. Campbell-Walsh urology. 10th ed. New York: Elsevier; 2011.

    Google Scholar 

  • Pfister C, Ravasse P, Barret E, Petit T, Mitrofanoff P. The value of endoscopic treatment for ureteroceles during the neonatal period. J Urol. 1998;159:1006–9.

    Article  PubMed  CAS  Google Scholar 

  • Prieto J, Ziada A, Baker L, Snodgrass W. Ureteroureterostomy via inguinal incision for ectopic ureters and ureteroceles without ipsilateral lower pole reflux. J Urol. 2009;181:1844–50.

    Article  PubMed  Google Scholar 

  • Rich MA, Keating MA, Snyder HM, Duckett JW. Low transurethral incision of single system intravesical ureteroceles in children. J Urol. 1990;144:120–1.

    Article  PubMed  CAS  Google Scholar 

  • Scherz HC, Kaplan GW, Packer MG, Brock WA. Ectopic ureteroceles: surgical management with preservation of continence-review of 60 cases. J Urol. 1989;154:538–41.

    Article  Google Scholar 

  • Share JC, Lebowitz RL. Ectopic ureterocele without ureteral and calyceal dilatation (ureterocele disproportion): findings on urography and sonography. AJR Am J Roentgenol. 1989;152(3):567–71.

    Article  PubMed  CAS  Google Scholar 

  • Shokeir AA, Nijman RJ. Ureterocele: an ongoing challenge in infancy and childhood. BJU Int. 2002;90(8):777–83.

    Article  PubMed  CAS  Google Scholar 

  • Srougi V, Yorioka M, Sanchez DCJ, Onal B, Houck CS, Nguyen HT. The feasibility of robotic urologic surgery in infants and toddlers. J Pediatr Urol. 2013;9:1198–203.

    Article  PubMed  Google Scholar 

  • Stephens FD. Caecoureterocele and concepts on embryology and aetiology of ureteroceles. Aust N Z J Surg. 1971;40:239–48.

    Article  PubMed  CAS  Google Scholar 

  • Tanagho EA. Embryologic basis for lower ureteral anomalies: a hypothesis. Urology. 1976;7(5):451–64.

    Article  PubMed  CAS  Google Scholar 

  • Tokunaka S, Gotoh T, Koyanagi T, Tsuji I. Morphological study of the ureterocele: a possible clue to its embryogenesis as evidenced by a locally arrested myogenesis. J Urol. 1981;126(6):726–9.

    Article  PubMed  CAS  Google Scholar 

  • Tomaszewski JJ, Turner RM, Ost MC. Stone cobras: adult bilateral single system ureteroceles presenting with multiple calculi. Urology. 2011;78(4):782–3.

    Article  PubMed  Google Scholar 

  • Upadhyay J, Bolduc S, Braga L, Farhat W, Bagli DJ, McLorie GA, Khoury AE, El-Ghoneimi A. Impact of prenatal diagnosis on the morbidity associated with ureterocele management. J Urol. 2002;167:2560–5.

    Article  PubMed  Google Scholar 

  • Vergani P, Ceruti P, Locatelli A, Mariani E, Paterlini G, Zorloni C, Ghidini A. Accuracy of prenatal ultrasonographic diagnosis of duplex renal system. J Ultrasound Med. 1999;18:463–7.

    Article  PubMed  CAS  Google Scholar 

  • Zerin JM, Baker DR, Casale JA. Single-system ureteroceles in infants and children: imaging features. Pediatr Radiol. 2000;30:139–46.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Children’s Healthcare of Atlanta, Atlanta, GA, USA

    Kristin M. Broderick

  2. Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA

    Andrew J. Kirsch

Authors
  1. Kristin M. Broderick
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Andrew J. Kirsch
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Beacon Hospital, University College Dublin, Dublin, Ireland

    Prem Puri

Rights and permissions

Reprints and permissions

Copyright information

© 2022 Springer-Verlag GmbH Germany, part of Springer Nature

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Broderick, K.M., Kirsch, A.J. (2022). Ureteroceles. In: Puri, P. (eds) Pediatric Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-38482-0_181-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-38482-0_181-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-38482-0

  • Online ISBN: 978-3-642-38482-0

  • eBook Packages: Springer Reference MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation