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    Korean J Urol. 2007 Mar;48(3):321-326. Korean.
    Published online Mar 31, 2007.
    https://doi.org/10.4111/kju.2007.48.3.321
    Copyright © 2007 The Korean Urological Association
    Original Article

    Clinical Manifestations and Indications for Management of Ureteroceles in Adults

    Tae Hee Oh, Dong Soo Ryu, and Jun O Kwon
      • Department of Urology, Masan Samsung Hospital, Sungkyunkwan University School of Medicine, Masan, Korea.
    • Corresponding author (Email: dsryumd@urology.or.kr )
    Received July 27, 2006; Accepted January 24, 2007.

    Abstract

    Purpose

    To review the clinical manifestations, indications and the management outcomes of adult patients with ureteroceles.

    Materials and Methods

    Between 1995 and 2006, 20 adult patients (9 females, 3 males) with ureteroceles were investigated for their clinical symptoms, type of ureterocele and renal function. The outcomes of surgical or conservative management, according to the patients' symptoms were also individually analyzed. The median follow-up was 38 months (12-50 months).

    Results

    The ages at diagnosis of the ureteroceles ranged from 19 to 70 years (mean 37.9 years). The ureterocele-related symptoms were flank pain (3), hematuria (1) and lower urinary tract symptoms (4). Two cases were incidentally detected with ultrasound (1) or computed tomography (1), and another 2 patients presented with non-specific flank pain or a hematuria. Eight patients exhibited an intravesical single system and 4 were associated with upper pole of a duplex system. Only one patient had an ectopic ureterocele, in which the orifice was located in the mid-urethra. The ureterocele-related symptoms were managed using a transurethral incision (5) or resection (1) of the ureterocele, with ureteroscopic stone retrieval (2). The symptoms were resolved after surgery, and there were no recurrence of symptoms or any deterioration of the renal function during follow-up.

    Conclusions

    To diagnose an ureterocele in adult patients requires a high index of suspicion, as not all patients present with the typical clinical manifestations associated in children. Our results suggested that ureterocele- related symptoms are the main indication for surgery in adult patients. While methods with lower morbidity may be a useful, expectant treatment, they may also be an appropriate option for the management of incidentally detected ureteroceles.

    Keywords
    Ureterocele; Adult

    Figures

    Fig. 1
    Computed tomography showing a right atrophied kidney (arrow) associated with an ipsilateral ureterocele.

    Fig. 2
    Intravenous pyelography (IVP) of a 40-year-old female, who presented with urinary interruption of 3 years duration. (A) Preoperative IVP showing an intravesical ureterocele of a single system. (B) Decreased size of the ureterocele after a transurethral incision of the ureterocele.

    Tables

    Table 1
    Patients' characteristics

    Table 2
    Presenting function on IVP or renal scan

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    MeSH Terms
    Adult*
    Child
    Diagnosis
    Female
    Flank Pain
    Follow-Up Studies
    Hematuria
    Humans
    Lower Urinary Tract Symptoms
    Recurrence
    Ultrasonography
    Ureterocele*
    Metrics
    Share
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    Tables
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