Ureterocele
A ureterocele is a swelling of the lower part of the ureter where it enters the bladder. It can partially block urine flow, sometimes causing infections or kidney problems. Some ureteroceles cause no symptoms and are found incidentally, while others may need treatment to prevent complications.
Overview | Symptoms & Causes | Diagnosis | Treatment Options
What is a Ureterocele?
The ureters are tubes that carry urine from the kidneys to the bladder. Normally, they enter the bladder in a way that acts like a one-way valve, helping urine flow in the right direction and preventing it from backing up into the kidneys.
A ureterocele is a condition present from birth where the lower end of the ureter swells, forming a small sac or balloon at its opening into the bladder. This can sometimes partially block urine flow, increasing the risk of urinary tract infections or kidney problems. However, many ureteroceles are small and cause no symptoms, often being found by chance during imaging for another reason.
Understanding Ureteroceles
Many ureteroceles cause no symptoms at all and are discovered by chance during imaging for another reason. When symptoms do occur, they are often related to urine flow obstruction or recurrent urinary tract infections (UTIs).
Common signs may include:
- Urinary tract infections (UTIs): Frequent infections, particularly in children, can be a clue to an underlying ureterocele.
- Frequent urination or urgency: Some people may notice the need to urinate more often or a sudden urge.
- Difficulty or pain when urinating: Partial obstruction can make passing urine uncomfortable or slow.
- Blood in the urine (haematuria): This can occur in some cases, especially if infections or irritation are present.
- Abdominal or flank pain: Pain in the lower abdomen or sides may develop if the ureterocele is causing urine to back up toward the kidney (hydronephrosis).
Symptoms can vary widely depending on the size of the ureterocele, whether it affects one or both ureters, and if it causes blockage of urine flow.
Causes & Risk Factors
Ureteroceles are usually a congenital condition, meaning they are present from birth. They occur when the ureter - the tube that drains urine from the kidney to the bladder - does not develop normally at its insertion point into the bladder. This abnormality causes the ureter to balloon, forming a cyst-like sac.
Certain factors can make ureteroceles more likely:
| Duplicated collecting system | Some kidneys have two ureters draining separately. Ureteroceles are more common in these cases, as one ureter may insert abnormally into the bladder. |
| Congenital anomalies | Other developmental issues of the urinary tract may be associated, although most ureteroceles occur on their own. |
| Rare genetic factors | While uncommon, a small number of cases may be linked to inherited conditions affecting urinary tract development. |
Most ureteroceles are sporadic, meaning they occur randomly without a clear inherited cause. They are present from birth, but symptoms may not appear until later in childhood or even adulthood, depending on the size and effect on urine flow.
Diagnosing a Ureterocele
If a ureterocele is suspected, your specialist will usually begin with a careful review of your symptoms and medical history, followed by imaging tests to confirm the diagnosis and assess the urinary tract. The aim is to understand the size and location of the ureterocele, whether it is affecting kidney function, and whether there are any associated anomalies such as a duplicated ureter.Common diagnostic tests include:
| Ultrasound | A painless and non-invasive scan that can show the cystic dilation of the ureter within the bladder. It also allows assessment of the kidneys for swelling or obstruction caused by the ureterocele. |
| CT Scan | This test provides more detailed images if the anatomy is complex, or if there is concern about obstruction or multiple ureters. It may help the specialist plan management if intervention is needed. |
| Voiding Cystourethrogram (VCUG) | ometimes recommended to check for urinary reflux or blockage at the bladder outlet. This involves filling the bladder with a safe contrast agent and taking X-ray images while you urinate. |
| Blood Tests | Kidney function tests, including creatinine and eGFR, are used to ensure the ureterocele is not impairing renal function. |
Treatment Options
The approach to managing a ureterocele depends on its size, the presence of symptoms, and whether it is affecting kidney function. Many small ureteroceles that cause no problems can be safely monitored over time with periodic ultrasound scans.
For ureteroceles that cause urinary tract infections, obstruction, or other issues, treatment options include:
| Management of UTIs | Prompt treatment of urinary tract infections with antibiotics helps prevent kidney damage and reduces discomfort. |
| Endoscopic incision or puncture | A minimally invasive procedure performed through the bladder to open the ureterocele, allowing urine to flow normally and relieving obstruction. |
| Surgical repair | In more complex cases - such as large ureteroceles, those associated with duplicated ureters, or when kidney function is at risk - surgery may be required to correct the anatomy and protect renal function. |
With careful monitoring and timely treatment when needed, most ureteroceles can be managed effectively, and serious complications are uncommon.
How can Lanthorn help?
Urinary Tract Ultrasound - £300
This first-line, non-invasive test allows our specialists to detect a ureterocele, check the kidneys, and identify any urinary obstruction. Ultrasound is safe, quick, and provides valuable information about the structure and function of the urinary tract.
Urinary Tract CT Scan - From £450
For more complex cases or when detailed anatomical information is needed, advanced imaging with CT can be performed. This test provides a clear picture of the ureters, bladder, and kidneys, helping guide appropriate management.
Kidney Function Blood Test - £99
Blood tests, including creatinine and eGFR, allow us to check how well your kidneys are working. These tests help ensure that the ureterocele is not affecting kidney function and guide decisions on monitoring or treatment.
