Like the obstructed megaureter mentioned in the previous paragraph, ureterocele is due to a stenosis of the ureterovesical (ureter-bladder) junction.
However this stenosis is of a particular type, resulting to a situation where the last part of the dilated ureter appears as a cyst in the inside of the urinary bladder.
IN GENERAL
Girls who suffer from ureterocele tend to be suffering from duplex kidneys as well. In that case the stenosis concerns that ureter that connects the bladder to the upper part of the dupley kidney.
On the contrary, boys who suffer from ureterocele are rarely diagnosed with duplex kidneys. In this case a single ureter connects each single kidney to the bladder. Diagnosis of an ureterocele is usually achived (as in the case of an obstructed megaureter) during the prenatal ultrasound test. The gravity of the ureterocele is proportional to that of the hydronephrosis. In this case and contrary to the case of an obstructed megaureter, a natural amelioration, without the necessary therapy, should not be expected except in rare cases of small ureteroceles.
DIFFERENT TYPES OF URETEROCELES
They exist two types of ureterocele. Orthotopic (intravesical) ureterocele and Ectopic (extravesical) ureterocele. In the first case, the dilated part of the ureter that protrudes into the urinary bladder remains contained in it.
In the case of an ectopic ureterocele, the dilated part not only protrudes into the urinary bladder but also into the urethra (the tube that connects the urinary bladder to the genital for the removal of fluids out of the body). In some cases urinal continence problems might be observed among older people, who have suffered from ectopic ureterocele in the past. Rarely does the dilated part protrude outside the urethra and into a girl’s vagina.
THERAPY
In late years, surgeons tented to remove the dilated upper part of the duplex kidney (partial-upper pole nephrectomy) or to operate the patient, removing the last part of the ureter and proceeding to its reimplantation inside the urinary bladder.
Nowdays, the usual method implies an, rather light for the child, endoscopic operation that consists of opening, by the means of a small waterproof electronic knife, a small hole through which the ureter and the kidney will be drained adequately. This operation does not call for hospitalization of the child, nor for use of an urinary catheter post surgically. Once the operation has been carried out, further open surgery related to the problem is avoided in at least 90% of the cases.
Υπερηχογράφημα σε παιδί με ΑΡ ουρητηροκήλη. Διακρίνεται η «κύστη» της ουρητηροκήλης που προβάλει μέσα στο εσωτερικό της κοιλότητος της ουροδόχου κύστης.
