Sometimes your little one may have frequent urinary tract infections (UTIs). Or they may complain of stomach aches. Most of the time, we think of these as normal things, but sometimes there could be a small problem that is present from birth. That is what a condition called 'Ureterocele' is. Although the name may sound a bit scary, if we understand it properly, it is something that can be managed. So today, let's talk about this in a simple way that you can understand.
Simply put, what is Ureterocele?
Okay, let's understand this this way. We have two kidneys in our body. What these kidneys do is filter our blood and remove unwanted waste products as urine. The urine that is produced in this way is collected in the bladder through two tubes. We call these two tubes ureters . One ureter comes from each kidney.
Now imagine that the end of this urethra, where it connects to the bladder, is bulging like a small balloon. That's what we call a ureterocele.
This balloon-like part prevents urine from flowing freely into the bladder. It's like a blockage. What happens then? Since the urine can't flow down properly, it starts flowing backwards towards the kidneys. We medically call this (vesicoureteral reflux) . This is the main problem with a ureterocele. Because urine flowing backwards is not good for the kidneys.
Are there types of ureterocele?
Yes, this situation can be classified into several main ways.
- Depending on whether it is on one side or both: Some children may have this condition in only one urethra (unilateral). That is the most common. However, very rarely, this dilation can occur in both urethras (bilateral).
- By location of the bulge: Also, these bulges are classified by where they are located inside the bladder. Some are confined to the bladder (intravesical). However, the most common type, especially in young children (extravesical), can extend down the bladder, to the tube that carries urine out (urethra).
These classifications are important for doctors to choose the treatment method that best suits the child.
What are the symptoms of a ureterocele?
The strange thing is, most of the time, a Ureterocele may not show any symptoms. However, as I mentioned earlier, there is a high chance of developing a Urinary Tract Infection (UTI) due to the urine not flowing properly and getting stuck. That's when the symptoms start to appear.
Check if your child has any of these symptoms. These could be signs of a urinary tract infection.
| Symptom | Simply put... |
|---|---|
| Pain when urinating | The child cries when urinating, or complains of pain. They may even say it feels like a burning sensation. |
| Smelly urine | The urine has a stronger, more foul odor than usual. |
| Stomach pain or a lump | It may feel like lower abdominal pain or a small lump that can be felt in the hand. |
| Blood in the urine | The urine turns pink or red. |
| Frequent need to urinate | Saying "I need to pee " more often than usual. |
| Inability to control urine | Even a child who is toilet trained may still urinate on their clothes without realizing it. |
| Bladder not emptying completely | Feeling like there is still urine in the bladder even after urinating. |
If your child shows any of these symptoms, see your doctor immediately.
Why is this happening? What is the reason for this?
This is a very important issue for parents. Ureterocele is a congenital condition. This means that when the baby is growing in the womb, the ureter, which I mentioned earlier, does not develop properly where it connects to the bladder.
This is not due to any mistake made by the mother during pregnancy, or to something she ate or drank, or to something she said or did. Researchers believe that this is a random occurrence. So never worry about it.
Sometimes the symptoms of this condition appear in adulthood. But even then, the cause is the same. It's something that was present in the body from birth.
Is this a serious condition? What are the complications?
Ureterocele is a serious condition that needs to be treated. But the best thing is that it can be cured. Problems arise if it is left untreated. The main risk is damage to the kidneys.
As urine flows backward into the kidneys, the kidneys can swell, become infected, and over time, permanently impair kidney function.
The most important thing is that kidney damage is irreversible. This means that once a kidney's function has been reduced to a certain extent, it is difficult to fully restore it. That is why it is extremely important to diagnose and treat this condition before kidney damage occurs.
Other complications may include:
- Kidney stones.
- Bladder damage.
- Recurrent urinary tract infections (UTIs).
How does a doctor find this?
This condition is often diagnosed before the baby is born. Yes, during prenatal ultrasounds . Usually done at around 20 weeks, doctors may suspect a kidney or ureter if they see swelling. Then, after the baby is born, they do more tests to confirm it.
But sometimes it is diagnosed after birth, around the age of 2. It can also be discovered accidentally in adults during tests for kidney stones or urinary tract infections.
Here are some tests that doctors use to diagnose this condition.
| Test | What does this do? |
|---|---|
| Kidney Ultrasound | The shape, size, and swelling of the kidneys and bladder are checked. |
| VCUG (Voiding Cystourethrogram) test | This is a special X-ray test. A small tube is inserted into the bladder and filled with a special liquid. An X-ray is taken while the child urinates. This can be used to check for reflux (backflow of urine) into the kidneys. |
| Renal Scan | This helps to monitor, as a percentage, how well the kidneys are working and whether they have been damaged. |
| CT or MRI scan | These scans can be used to obtain clearer, more detailed images of the urinary system. |
| Urine Test | This is definitely done to confirm whether you have a urinary tract infection (UTI). |
How is a ureterocele treated?
The treatment method is determined by considering several factors, such as the child's age, the size of the ureterocele, whether there is kidney damage, and whether urine is refluxing.
The main treatments are surgery and watchful waiting.
Surgical Treatments
The main goal of the surgery is to remove the balloon-like swelling and allow urine to flow freely. There are various surgical techniques for this.
| Surgical method | Simple explanation |
|---|---|
| Transurethral Puncture | This is the simplest method. Here, the surgeon inserts a thin tube with a camera (cystoscope) through the urethra to look inside the bladder. Then, a small hole is made in the balloon-like ureterocele. It is like blowing up a balloon. Then, the blocked urine flows easily. This is usually done under anesthesia and is an outpatient procedure. |
| Ureteral Reimplantation | This is a slightly more complicated surgery. A small incision is made in the lower abdomen to open the bladder. Then, the part of the ureter with the ureterocele is cut out and removed, and the healthy ureter is reconnected to the bladder, preventing urine from flowing backward (a flap valve mechanism). This surgery is 90%-95% successful. |
| Upper Pole Nephrectomy | Some children have a condition called a 'duplex kidney'. This means that one kidney is split into two parts. If the ureterocele severely damages the upper part of the kidney and it stops working, surgery is needed to remove the damaged part. |
Watchful Waiting
This procedure is often used in adults. If the ureterocele is not causing any symptoms or causing kidney damage, your doctor may decide to observe the condition for a while without surgery.
What is the child's outlook?
The outlook is very good. Because urinary retention is temporary. After it is corrected with surgery, the child can lead a normal life. The only thing to remember is that if the ureterocele has caused any damage to the kidneys, that damage is permanent. It cannot be undone. All we can do is stop further damage. That is why early diagnosis and treatment of this condition are important for life.
Take-Home Message
- Ureterocele is a congenital condition. It is not due to any fault of the parents.
- The main risk of this is that urine can back up and damage the kidneys.
- In most cases, this condition can be detected through scans before the baby is born.
- Surgery can completely cure this condition. The results are very successful.
- If your child has frequent urinary tract infections or complains of pain when urinating, don't ignore them. See a doctor immediately. Prompt treatment can help protect the kidneys.
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