A defect in the structure of the ureter, which is characterized by a cystic expansion of its distal part, is called a ureterocele. In this case, the cystic expansion swells into the cavity of the bladder. This pathology is diagnosed in childhood and may be accompanied by a doubling of the ureter. The cyst of the ureter can be either unilateral or bilateral. There are ectopic, prolapsing and simple ureterocele. What are the features of these types of ureterocele? Why does a ureteral cyst form, and what symptoms does it manifest?
Characterization of ureterocele types. Grades of congenital ureteral cyst
An ectopic ureteral cyst is located in an abnormally located ureter that opens into the urethra, bladder diverticulum, or vestibule.
The prolapsing variant of the ureterocele in girls can come out through the urethra. Externally, education has a dark – purple color, covered with ulcerated mucous membrane. In boys, a prolapsing ureterocele protrudes into the prostatic urethra, causing acute urinary retention. Read all the symptoms in the development of a ureteral cyst further on estet-portal.com. Ureterocele can be primary (congenital) or secondary.
There are 3 grades of congenital ureterocele:
- 1 degree – characterized by a slight expansion of the intravesical ureter. This is not accompanied by changes in upper urinary tract function;
- 2 degree – large cyst, its development is accompanied by the development of ureterohydronephrosis;
- 3 degree – characterized, in addition to ureterohydronephrosis, by severe dysfunction of the bladder.
Causes of ureterocele and mechanism of development of clinical manifestations
As a rule, ureterocele develops against the background of elongation of the intramural segment of the ureter and narrowing of its mouth. This narrowing develops against the background of a deficiency of muscle fibers in the distal ureter. Researchers claim that the cyst of the ureter develops due to a violation of the innervation of the lower ureter and adjacent tissues.
A ureteral cyst is always accompanied by a disturbed outflow of urine. This increases the hydrostatic pressure, which leads to overstretching of the bladder wall, after which it bulges into the intravesical bladder. The cavity of the ureterocele is surrounded by the walls of the ureter on one side and the stratified wall of the bladder on the other side. The ureterocele contains stones and purulent urine.
Violation of urinary excretion is accompanied by stagnation of urine, which leads to infection of the tissues of the excretory system. Cystitis, pyelonephritis develops, urinary stones form, provoking nephrosclerosis and loss of kidney function.
Acquired ureterocele is formed as a result of an incarcerated urinary stone in the intramural segment of the ureter.
Symptoms, possible complications and treatment of ureterocele
Ureterocele is manifested by urinary incontinence and pain. A large ureter cyst can occupy a large volume of the bladder, limiting its cavity. This is accompanied by frequent urination, urine is excreted in small portions.
If the protrusion of the mouth overlaps another ureter, acute hydronephrosis develops with a total violation of the outflow of urine. This condition is manifested by acute paroxysmal pains, similar to an attack of renal colic.
In women, the descent of the ureterocele into the urethra is accompanied by complete urinary retention. When trying to urinate in women, prolapse of the cyst is likely to come out. The prolapse of the cyst is intermittent and self-resets. Possible strangulation and necrosis of a prolapsed ureterocele in the urethra.
A patient with a ureterocele complains of persistent aching pain in the lower back and iliac region, painful urination, persistent recurrent urinary tract infections, and fever. A very pungent odor of urine is also noted.
At the first manifestations of a ureterocele, it is important for a patient to consult a urologist for diagnosis of the condition and timely treatment in order to prevent complications. Treatment of ureterocele is carried out only by surgery.
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