Ureters normally join the bladder through a narrow opening. Enlargement of the terminal ureter just before this opening is called ureterocele or cystic enlargement of the ureter.

This is a congenital defect or birth defect. Ureteric orifice is fibrotic and narrow developmentally. The wall of the this ureteric cyst can be very thin, as muscle coat is not properly developed.

Clinical features

This condition may not be discovered till adult life and only some children are detected in child hood. Women are more prone than men are. In 10% of cases it is seen on both sides. The common symptoms seen are

Pain

Repeated infection

Obstruction to passage of urine

Stone formation

Pain and infection are due to stasis of urine in the ureter; consequently raising the pressure in the kidney, which stretches the capsule of the kidney. Capsule of the kidney is the sensitive part producing pain. Kidney as such does not experience pain.

Treatment

Diagnosis is usually not possible by simple clinical examination. Additional tests like Intravenous pyelogram, ultrasound, are required only to ascertain the exact position and size of the ureterocele. Further additional tests like nuclear scan to assess the function and amount of stasis in the kidney may be necessary.

Many cases do not have any symptoms and if there is adequate drainage need not be treated. All complications listed above need treatment. Common surgical procedure to cure this condition is

Incision of the ureterocele

Cutting the ureter above the ureterocele and performing a new bladder opening.

Your urologist will be able to advise you on further management.