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Fetal Ureterocele

Ureterocele_s.gifAn ureterocele is a balloon-like malformation of the area where a ureter, the tube from the kidney, enters the bladder. This balloon-like structure causes problems by blocking the normal flow of urine from the kidney causing it to accumulate in the ureter and in the kidney. This blockage, if not corrected, can cause the kidney to lose its ability to purify blood and produce urine, and it can also give rise to dangerous infections after birth. For these reasons this is an important medical problem even though the baby may appear to be normal at birth.

Diagnosis

Ureteroceles are diagnosed prenatally (before birth) using ultrasound (also known as a ‘sonogram'). Sometimes magnetic resonance imaging (MRI) is useful to confirm the diagnosis. Most often the sonogram is repeated after birth to confirm the diagnosis. Other imaging techniques such as IVP (intravenous pyelogram) or retrograde cystogram are sometimes employed after birth. Learn about fetal MRI.

Specialists in the Institute for Fetal Health can consult parents expecting a child with ureteroceles.

Symptoms

There are no symptoms of ureterocele in the baby before birth, and at the time of birth the newborn examination may be completely normal. In the newborn period, swelling may be noted and urinary infection may develop. One problem with this abnormality is that symptoms may not be present until after damage to the kidney has occurred.

Treatm​ent

The condition usually requires a simple operation shortly after birth to cut the balloon-like structure so that urine may freely drain into the bladder. This procedure is called a cystoscopy and is performed under general anesthesia without making an external incision (cut in the skin). When the problem can be corrected with cystoscopy, it is usually done as an outpatient procedure, and the baby can go home later that day without significant pain. Sometimes more extensive surgery is necessary. It is important to correct the urine blockage, if possible, before damage to the kidney has occurred.

Long-term Effects

Once normal urine flow is established, children are watched carefully for infection, but the outlook for normal urinary function is very good.

Overview
 
An ureterocele is a balloon-like malformation of the area where a ureter, the tube from the kidney, enters the bladder. This balloon-like structure causes problems by blocking the normal flow of urine from the kidney causing it to accumulate in the ureter and in the kidney. This blockage, if not corrected, can cause the kidney to lose its ability to purify blood and produce urine, and it can also give rise to dangerous infections after birth. For these reasons this is an important medical problem even though the baby may appear to be normal at birth.
Diagnosis & Treatment
Ureteroceles are diagnosed prenatally (before birth) using ultrasound (also known as a ‘sonogram'). Sometimes magnetic resonance imaging (MRI) is useful to confirm the diagnosis. Most often the sonogram is repeated after birth to confirm the diagnosis. Other imaging techniques such as IVP (intravenous pyelogram) or retrograde cystogram are sometimes employed after birth. Learn about fetal MRI.

Symptoms
There are no symptoms of ureterocele in the baby before birth, and at the time of birth the newborn examination may be completely normal. In the newborn period, swelling may be noted and urinary infection may develop. One problem with this abnormality is that symptoms may not be present until after damage to the kidney has occurred.

Treatment
The condition usually requires a simple operation shortly after birth to cut the balloon-like structure so that urine may freely drain into the bladder. This procedure is called a cystoscopy and is performed under general anesthesia without making an external incision (cut in the skin). When the problem can be corrected with cystoscopy, it is usually done as an outpatient procedure, and the baby can go home later that day without significant pain. Sometimes more extensive surgery is necessary. It is important to correct the urine blockage, if possible, before damage to the kidney has occurred.

Long-Term Effects
Once normal urine flow is established, children are watched carefully for infection, but the outlook for normal urinary function is very good.