The cause of this erroneous development of the ureter opening remains unknown. 

About one in every thousand newborns has a condition called ureteroceles, which is more common in a duplex kidney. Duplex kidney refers to two ureters connected in a single kidney and draining to separate openings or none at all.

Ureteroceles usually do not cause symptoms unless the condition has led to an infection of the urinary tract (UTI). Some signs of a UTI are:

• Pain during urination and a burning sensation while voiding
• Foul-smelling urine
• Pain or a lump in the abdominal area, particularly where the bladder is located
• Urine with blood
• Fever
• Frequent urination
• Urinary incontinence
• Unable to fully empty the bladder

Ultrasound is the best method by far in detecting a ureterocele. An ultrasound is an excellent way to find the ureterocele in the bladder and the swelling (hydronephrosis) of the kidney. When a ureterocele is found, other tests are often done, such as urinalysis and urodynamic tests.

A radionuclide scan is a type of x-ray that checks how well a kidney works.

When a person has a duplex kidney, another test called a VCUG is done to see if urine from the kidney flows backward or into the other ureter. 

Treatment

Depending on the degree of the dilatation, a low dose of prophylactic antibiotics is often advised if a ureterocele is identified before birth. 

A minor procedure called a ureterocele puncture is often done in the first few weeks of life. In this procedure, a small camera is put into the bladder through the urethra. The ureterocele in the bladder is then punctured (or “popped”) to remove any blockage. If an infant or child has a ureterocele and a severe infection, a ureterocele puncture is done as soon as possible.

Treatment for ureteroceles in older children can vary based on a number of factors, including the kidney’s overall health, the size of the ureterocele, the degree to which the ureter and kidney have been dilated, the presence or absence of reflux in the kidney’s contralateral ureter, and so on. 

Renal ultrasounds are repeated at regular intervals after a ureterocele is punctured to check for signs of dilatation and to see if the ureterocele has disappeared. 

It is common practice to perform a VCUG following a puncture, particularly if there is a UTI after the puncture, to screen for reflux. Antibiotics can be taken for a long time to prevent urinary tract infections.

About half of the time, after a ureterocele puncture, when the urine flows backward, surgery is needed to fix this.

When a child has surgery to fix a ureterocele, the kidneys are often checked with periodic ultrasounds to ensure the kidneys are growing and draining well.

Unfortunately, ureterocele is unpreventable as it is a congenital anomaly. A prenatal checkup to view the abnormal ureter is one of the ways to have early interventions. If this happens, secure a meeting with specialists such as urologists to tackle immediate and long-term treatments.

References

University of California San Francisco (2022). Ureteroceles. Retrieved December 22, 2022, from https://urology.ucsf.edu/patient-care/children/urinary-tract-obstruction/ureteroceles

Cleveland Clinic (2022). Ureterocele. Retrieved December 22, 2022, from https://my.clevelandclinic.org/health/diseases/16322-ureterocele