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Symptomatic Ureterocele in 59-Year-Old Woman: Surgical Management of Adult Ureterocele

Received: 21 August 2022     Accepted: 28 October 2022     Published: 4 November 2022
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Abstract

To investigate the presentation and management of ureteroceles remaining asymptomatic until adulthood. A ureterocele is a congenital cystic dilation of the distal ureter upon its entry point into the bladder. This birth defect obstructs urine flow and can negatively impact proper renal function. Treatment options vary widely depending on the type of ureterocele and the presence or absence of a duplicated collecting system. We present a rare case of a 59-year-old female with a symptomatic left intravesical single system ureterocele successfully managed with endoscopic resection. Ureteroceles are commonly diagnosed in utero or within the first few years of life. However, primarily due to her asymptomatic nature until nearly 60 years of age, our patient offers an unusual presentation of a ureterocele diagnosed initially in adulthood. Various classification systems are employed in the diagnosis of ureteroceles, however the Ericsson and Glassberg classification systems are most widely used. A duplex kidney is a common finding in ureterocele cases and typically necessitates a more complex treatment plan. The management of ureteroceles varies based on classification, presence of symptoms, age, severity, and concurrent complications. As seen with our patient, a significant symptomatic presentation may warrant surgical intervention via endoscopic resection of the ureterocele. Ureteroceles can be managed using conservative treatment or surgical intervention via endoscopic resection, as seen in our patient. If surgical intervention is pursued, patients should be continually monitored for postoperative complications including hydronephrosis and urinary tract infections.

Published in International Journal of Clinical Urology (Volume 6, Issue 2)
DOI 10.11648/j.ijcu.20220602.17
Page(s) 114-118
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Ureterocele, Case Report, Asymptomatic, Urology, Orthotopic

References
[1] Glassberg, K. I., Braren, V., et al (1984). Suggested terminology for duplex systems, ectopic ureters and ureteroceles. Journal of Urology, 132 (6), 1153–1154. https://doi.org/10.1016/s0022-5347(17)50072-5
[2] Geringer, A. M., et al. (1983). The diagnostic approach to ectopic ureterocele and the renal duplication complex. Journal of Urology, 129 (3), 539–542. https://doi.org/10.1016/s0022-5347(17)52225-9
[3] Merlini, E., & Lelli Chiesa, P. (2004). Obstructive ureterocele?an ongoing challenge. World Journal of Urology, 22 (2). https://doi.org/10.1007/s00345-004-0407-y
[4] Peppas, D. S., et al. (1991). Nonsurgical management of primary vesicoureteral reflux in complete ureteral duplication: Is it justified? Journal of Urology, 146 (6), 1594–1595. https://doi.org/10.1016/s0022-5347(17)38176-4
[5] Timberlake, M. D., et al. (2015). Minimally invasive techniques for management of the ureterocele and ectopic ureter. Urologic Clinics of North America, 42 (1), 61–76. https://doi.org/10.1016/j.ucl.2014.09.006
[6] Shah, Hemanshi, et al. “Transurethral incision of ureteroceles in paediatric age group.” Turkish journal of urology vol. 43, 4 (2017): 530-535.
[7] Sander JC, Bilgutay AN, et al. Outcomes of endoscopic incision for the treatment of ureterocele in children at a single institution. J Urol. 2015 Feb; 193 (2): 662-6.
[8] Schultza K, Todab LY. Genetic basis of ureterocele. Current Genomics. 2016; 17: 62–9.
[9] Atta, Omar N., et al. “An adult ureterocele complicated by a large stone: A case report.” International journal of surgery case reports vol. 44 (2018): 166-171.
[10] Ericcson N. O. Ectopic ureterocele in infants and children. Acta Chir Scand Supplement. 1954; 197: 8–14.
[11] Stephens F. D. Aetiology of ureteroceles and effects of ureteroceles on the urethra. Br J Urol. 1968; 40: 483–7.
[12] Coplen D. E., Duckett J. W. The modern approach to ureteroceles. J Urol. 1995; 153: 166–71.
[13] Shokeir AA, Nijman RJM. Ureterocele: an ongoing challenge in infancy and childhood. BJU Int. 2002; 90: 777–83.
[14] Osipov, I. B., Lebedev, D. A. & Lifanova, M. V. Kidney triplication with ectopic ureterocele: a case report. BMC Urol 20, 54 (2020). https://doi.org/10.1186/s12894-020-00625-2.
[15] Chauhan G, Levy I, Samuel SW. Ureterocele as a cause of chronic intractable abdominal pain. BMJ Case Reports CP 2021; 14: e245262.
Cite This Article
  • APA Style

    Sarah Johnson, Samuel Huff, Thomas Barefoot, Kellen Choi. (2022). Symptomatic Ureterocele in 59-Year-Old Woman: Surgical Management of Adult Ureterocele. International Journal of Clinical Urology, 6(2), 114-118. https://doi.org/10.11648/j.ijcu.20220602.17

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    ACS Style

    Sarah Johnson; Samuel Huff; Thomas Barefoot; Kellen Choi. Symptomatic Ureterocele in 59-Year-Old Woman: Surgical Management of Adult Ureterocele. Int. J. Clin. Urol. 2022, 6(2), 114-118. doi: 10.11648/j.ijcu.20220602.17

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    AMA Style

    Sarah Johnson, Samuel Huff, Thomas Barefoot, Kellen Choi. Symptomatic Ureterocele in 59-Year-Old Woman: Surgical Management of Adult Ureterocele. Int J Clin Urol. 2022;6(2):114-118. doi: 10.11648/j.ijcu.20220602.17

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  • @article{10.11648/j.ijcu.20220602.17,
      author = {Sarah Johnson and Samuel Huff and Thomas Barefoot and Kellen Choi},
      title = {Symptomatic Ureterocele in 59-Year-Old Woman: Surgical Management of Adult Ureterocele},
      journal = {International Journal of Clinical Urology},
      volume = {6},
      number = {2},
      pages = {114-118},
      doi = {10.11648/j.ijcu.20220602.17},
      url = {https://doi.org/10.11648/j.ijcu.20220602.17},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcu.20220602.17},
      abstract = {To investigate the presentation and management of ureteroceles remaining asymptomatic until adulthood. A ureterocele is a congenital cystic dilation of the distal ureter upon its entry point into the bladder. This birth defect obstructs urine flow and can negatively impact proper renal function. Treatment options vary widely depending on the type of ureterocele and the presence or absence of a duplicated collecting system. We present a rare case of a 59-year-old female with a symptomatic left intravesical single system ureterocele successfully managed with endoscopic resection. Ureteroceles are commonly diagnosed in utero or within the first few years of life. However, primarily due to her asymptomatic nature until nearly 60 years of age, our patient offers an unusual presentation of a ureterocele diagnosed initially in adulthood. Various classification systems are employed in the diagnosis of ureteroceles, however the Ericsson and Glassberg classification systems are most widely used. A duplex kidney is a common finding in ureterocele cases and typically necessitates a more complex treatment plan. The management of ureteroceles varies based on classification, presence of symptoms, age, severity, and concurrent complications. As seen with our patient, a significant symptomatic presentation may warrant surgical intervention via endoscopic resection of the ureterocele. Ureteroceles can be managed using conservative treatment or surgical intervention via endoscopic resection, as seen in our patient. If surgical intervention is pursued, patients should be continually monitored for postoperative complications including hydronephrosis and urinary tract infections.},
     year = {2022}
    }
    

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    AU  - Sarah Johnson
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    AB  - To investigate the presentation and management of ureteroceles remaining asymptomatic until adulthood. A ureterocele is a congenital cystic dilation of the distal ureter upon its entry point into the bladder. This birth defect obstructs urine flow and can negatively impact proper renal function. Treatment options vary widely depending on the type of ureterocele and the presence or absence of a duplicated collecting system. We present a rare case of a 59-year-old female with a symptomatic left intravesical single system ureterocele successfully managed with endoscopic resection. Ureteroceles are commonly diagnosed in utero or within the first few years of life. However, primarily due to her asymptomatic nature until nearly 60 years of age, our patient offers an unusual presentation of a ureterocele diagnosed initially in adulthood. Various classification systems are employed in the diagnosis of ureteroceles, however the Ericsson and Glassberg classification systems are most widely used. A duplex kidney is a common finding in ureterocele cases and typically necessitates a more complex treatment plan. The management of ureteroceles varies based on classification, presence of symptoms, age, severity, and concurrent complications. As seen with our patient, a significant symptomatic presentation may warrant surgical intervention via endoscopic resection of the ureterocele. Ureteroceles can be managed using conservative treatment or surgical intervention via endoscopic resection, as seen in our patient. If surgical intervention is pursued, patients should be continually monitored for postoperative complications including hydronephrosis and urinary tract infections.
    VL  - 6
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Author Information
  • School of Medicine, University of Louisville, Louisville, USA

  • School of Medicine, University of Louisville, Louisville, USA

  • School of Medicine, University of Louisville, Louisville, USA

  • Department of Urology, University of Louisville Health, Louisville, USA

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