Ureterocele in Children

Ureterocele Causes

While some ureteroceles are very small, others can become quite large and take up the entire bladder. Small ureteroceles, the most common type, generally have a mild effect on the flow of urine. However, larger ureteroceles can lead to more severe obstruction, causing problems such as urinary tract infections (UTIs), vesicoureteral reflux (when urine backs up into the kidney) and kidney damage.

The cause of ureteroceles is unknown. The condition is typically present at birth (congenital), which means it may be a problem with fetal development of the urinary tract. The condition also tends to run in families, so there may be a genetic component as well.

Ureteroceles are more common in girls than boys. Ureteroceles often affect both of a girl’s ureters, while it’s more common to have only one ureter affected in boys.

Ureterocele Symptoms

Ureteroceles often don’t cause any symptoms, especially if it is a milder form. It’s often detected on a prenatal ultrasound. If it’s not discovered before birth, infants and children with ureteroceles may develop recurrent UTIs. Symptoms of UTI include:

• Bad-smelling urine
• Blood in the urine
• Diarrhea
• Difficulty urinating
• Fatigue
• Fever and/or chills
• Irritability/fussiness in infants
• Nausea or vomiting
• Pain above the pubic bone, in the back or below the ribs
• Poor feeding in infants
• Sudden need to urinate or needing to pee more often
• Urinary incontinence

Ureterocele Diagnosis

A ureterocele is often diagnosed in utero with a prenatal ultrasound. Diagnosis after birth is often prompted when an infant or child has a urinary tract infection. Your child’s provider will perform a physical exam and take a complete medical history. Additional diagnostic tests include:

• Blood and urine tests: These can show how the kidneys are functioning, test for infection and measure levels of protein, chemicals and other substances in the urine.
• Urinary tract ultrasound: This procedure uses sound waves to look at the kidneys, bladder and other internal organs.
• Voiding cystourethrogram (VCUG): A catheter is placed through your child’s urethra into the bladder, slowly filling the bladder with a solution. A special machine called fluoroscopy takes pictures. The test can determine if any of the solution is going back up into the kidneys.
• Renal scan: This is a nuclear imaging test in which radioactive fluid is injected into a vein and is carried to the kidneys, where it gives off signals that can be captured with a special camera. This test can show how well the kidneys are filtering and draining.

Ureterocele Treatment

Treatment of a ureterocele depends on the severity of the condition, along with factors such as your child’s symptoms, age and general health. Severe ureteroceles that are not treated may cause recurrent UTIs and kidney damage.

Treatment options include:

• Observation: When the ureterocele is small with few or no symptoms, your child’s healthcare provider may recommend simple observation may be recommended. Follow-up imaging studies in a few months can help determine if there is any change.
• Antibiotics: Antibiotics, in the form of oral medication or intravenous infusion at the hospital, can treat UTIs and prevent future infections.
• Surgery: Surgery may be necessary in severe cases. Procedures may include:
  • Draining the ureter
  • Removing the ureterocele
  • Removing the damaged portion of the kidney (nephrectomy)